Health and Human Services (HHS) Secretary Tommy Thompson has announced ‘…that the current efforts being undertaken by the Department regarding Evaluation and Management (E+M) guidelines have been postponed. The announcement was made at a hearing of the House Ways and Means Committee…’ This is an effort to create usable billing codes similar to the AMA’s CPT billing codes. Unlike the AMA’s CPT codes which require a fee for use, these will be in the public domain. This presents a great opportunity for U.S. physicians to really open up the discussions concerning E&M guidelines and even CPT’s.

I *URGE* physicians to write to the contact address below. Introduce the concept of open discussions to these people. Maybe one of you could even start a yahoogroups list or sponsor a mailinglist yourself. :->

From: HBMA Announcement List [mailto:announce@listserv.hbma.com]

Sent: Thursday, July 19, 2001 6:00 PM

To: announce@listserv.hbma.com

Subject: Evaluation and Management Guidelines Sidelined!

July 19, 2001

MEMORANDUM via e-mail

To: HBMA Membership

From: Debra Hardy Havens, Bill Finerfrock, and Matt Williams

Re: Evaluation and Management Guidelines Sidelined

Health and Human Services (HHS) Secretary Tommy Thompson announced on
July 19 that the current efforts being undertaken by the Department
regarding Evaluation and Management (E+M) guidelines have been
postponed. The announcement was made at a hearing of the House Ways and
Means Committee.

The written testimony provided by the Secretary is as follows:

Another bold step that I want to announce today is a change in our
development of the new Evaluation and Management (E+M) guidelines that
physicians use to bill Medicare for their doctor visits. We know that
physicians’ primary work is to provide clinical care, not
documentation. We have been working on a third version of the
guidelines, which are based on the AMA’s Current Procedural Terminology
(CPT) that physicians use to bill insurance companies. Physicians found
the first two sets of guidelines, developed in 1995 and 1997,
cumbersome. We agree, and have been working with a contractor, Aspen
Systems, to improve them, but physicians have continued to express
concern that these guidelines are hindering, not helping, the delivery
of appropriate patient care.

We had hoped that this current effort would be a way to reduce burdens
on physicians, but it appears it needs another look. So I have directed
Aspen Systems to stop their work on this current draft while we reassess
and re-tune our effort. Additionally, I am turning to the physician
community to help design constructive solutions. After six years of
confusion, I think it makes sense to try to step back and assess what we
are trying to achieve. We need to go back and re-examine the actual
codes for billing doctor visits. For the system to work, the codes for
billing these visits need to be simple and unambiguous. I look forward
to working with the AMA and other physician groups to simplify the codes
and make them as understandable as possible.

More details are forthcoming on the July 19 Ways and Means hearing. In
the meantime, please contact us with questions or comments.

Please direct any response to:

Bradley J. Lund, Executive Director

Healthcare Billing and Management Association

1550 S. Pacific Coast Highway, Suite 201

Laguna Beach, CA 92651

(877) 640-4262-Ex: 203-telephone

(949) 376-3456-Fax

brad@hbma.com-e-mail

www.hbma.com -web site