Medicare sign-up question about accepting new patients becomes optional

CMS says it will change physician enrollment forms after the American Medical Association raised concerns.

By Charles Fiegl — Posted Oct. 6, 2011

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The agency overseeing the Medicare program will not require physicians to report whether they are accepting new Medicare patients or providing advanced imaging care.

The change comes after the American Medical Association wrote the Centers for Medicare & Medicaid Services about two new mandatory questions added to the program's enrollment applications in July. One question on paper and online versions of the application asks physicians, "Do you accept new Medicare patients?" Another question found only on the Web-based application asked, "Are you, or will you be, providing advanced diagnostic imaging services?"

"Committing to make these fields optional is an important step to help alleviate some of the challenges physicians face during the enrollment process, and we will continue to monitor the forms to ensure the action is completed," AMA President Peter W. Carmel, MD, said in a statement.

In an Aug. 4 letter, the AMA asked CMS to remove both questions from the application process. Acceptance of new patients is not a condition for participating in the Medicare program, and the advanced diagnostic imaging services question also was unnecessary, the association said.

The AMA also had concerns that the new patient question was a way to revive the CMS mystery shopper program, the letter said. In April, the Medicare agency revealed that it planned to use contractors posing as patients to call physician offices to inquire if they accepted patients with public insurance. The contractors then would have called again posing as patients with private insurance. The agency would have compared the results to determine the timeliness of available primary care services for those with private or public coverage.

CMS shelved the program indefinitely after strong negative reaction.

The Medicare agency has taken steps to make both fields optional, CMS Administrator Donald M. Berwick, MD, wrote in a Sept. 7 letter to the AMA. However, the sign-up form used for individual physician enrollment had not been updated as of this article's deadline.

Dr. Berwick insisted that the question about new patients was added to the forms solely to enhance the agency's Physician Compare website. CMS has launched a search directory on the site that patients can use to find doctors. Physician responses to the new patient question would be added to the directory.

"Beneficiary feedback indicated that this would be a very valuable piece of information to have when they are searching for a Medicare provider," he said.

Medicare statute requires health professionals who provide advanced diagnostic imaging tests to be accredited by Jan. 1, 2012. However, the AMA noted that accrediting organizations -- the American College of Radiology, the Intersocietal Accreditation Commission and the Joint Commission -- already report the information to CMS, making the additional query about imaging services unnecessary.

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