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CMS to track refusal to accept Medicare patients. (Monitoring Beneficiaries' Access Problems).

BALTIMORE -- The Centers for Medicare and Medicaid Services has upgraded its efforts to track beneficiaries' access to care across the country.

Anecdotal reports that Medicare beneficiaries cannot find physicians willing to accept them as new patients prompted the new initiative, CMS officials reported at a meeting of the Medicare Practicing Physician Advisory Council.

The council is composed of 15 physicians nominated by medical organizations and appointed by the HHS secretary. The council advises the HHS secretary on regulations and carrier manual instructions relating to physician services.

The agency will monitor what types of access problems that beneficiaries are experiencing and where they are occurring, according to Dan Waldo, director of CMS's Officeof Research, Development, and Information (ORDI), and Frank Eppig, ORDI deputy director.

The agency will track the volume and content of beneficiary inquiries to the national 800-Medicare phone number.

Operators have been given a list of questions to ask callers so that their specific problem and region of the country can be identified, Mr. Waldo and Mr Eppig reported at the meeting, also sponsored by the Department of Health and Human Services.

The information will allow CMS to count the number of inquiries relating to physicians dropping out of Medicare or physicians refusing to accept new Medicare patients.

CMS will also track the number of beneficiary inquiries that come into local Medicare carriers, examine daims data, and conduct beneficiary surveys.

Some council members expressed concern that beneficiaries may not be aware of the national toll-free phone number to use when inquiring about access questions. The council recommended that CMS improve reporting to the monitoring system by putting the 800-Medicare number on the back of beneficiaries' Medicare cards.

The council also recommended that CMS study whether physicians in certain specialties are more likely to turn away Medicare patients.

Once initial data collection has been completed, the ORDI will prepare a report on Medicare beneficiary access to physician services, Mr. Waldo and Mr. Eppig announced. The first ORDI report on access is expected to be released sometime this fall.
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Title Annotation:Centers for Medicare and Medicaid Services
Author:Peters, Sally
Publication:Internal Medicine News
Geographic Code:1USA
Date:Jul 15, 2002
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