Physician responsibility polarizes respondents

Tuesday, August 31, 2004

YARMOUTH, Maine - The frustration brewing over the CMN, progress notes and payment of equipment was evident in the replies of some 200 HME News Poll respondents last month, with more than half calling for physicians to take financial responsibility for the equipment they prescribe.

Forty percent of HME providers who replied said doctors should be held financially accountable, and many expressed frustrations that they were at the mercy of the doctor’s progress notes during the Medicare audit process even if the CMN indicated medical necessity.

“It is ultimately up to the DME company to provide proof of medical necessity, yet we have no medical documentation available to us unless it is provided by the physician or medical records,” said Carol Kopp of Med-Equip in Ridley Park, Pa. “It makes no sense to hold the DME company responsible without holding the physician responsible.”

Since physicians have the most information on a patient’s medical history and condition, he or she should be the point person for all clinical decisions, said many respondents. And, providers should be able to trust the doctor’s determinations as legitimate without second guessing or worrying that the prescription was written merely to appease the patient.

“The CMN clearly states that the physician is subject to civil and criminal penalties for false information,” said John Hayes, client specialist at Knowledge Concepts in Indian Trail, N.C. “If CMS will enforce this, they will educate the physicians and it will be the easiest and least expensive method to minimize abuse.”

In opposition, 60% of poll respondents adamantly disagreed and some expressed outrage over the “simplistic and one-sided poll question.”

“Should ministers be held liable in divorce courts?” opined Matthew Morris.

A host of reasons supported their argument, including access to equipment, physician education and rising insurance premiums.

“If physicians are financially responsible for equipment they prescribe, they will be much less likely to prescribe it. Also, their insurance premiums - which are already catastrophically high - will likely increase even more,” said Jane Johnson. “That type of policy will ultimately hurt consumers the most by limiting choice and availability of equipment they need to remain independent.”