tci Medicare Compliance & Reimbursement - 2007 Issue 15

INDUSTRY NOTES: Medicare Already Has Toolkit For Finding Wasteful Doctors

Plus: Master the 1P, 2P and 3P modifiers to protect your bonus.Medicare could use "profiling" to find physicians who are providing too many services or being inefficient, said Bruce Steinwald with the Government Accountability Office at an April 3 presentation before the American Enterprise Institute.Medicare already has a "comprehensive claims database" that would make this kind of examination possible, Steinwald noted. The database covers all the services physicians provide to patients. Also, Medicare has enough physicians in each region to allow meaningful local comparisons. And the program has some experience in using methods to account for differences...

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