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Reduce Medicare paperwork, AAOS urges Congress
WASHINGTON--The American Association of Orthopaedic Surgeons (AAOS) this week encouraged Congress to challenge the Health Care Financing Administration (HCFA) to demonstrate the necessity for the scope of recordkeeping and reporting now required by HCFA and the Medicare Carriers.
St. Louis, Mo., orthopaedic surgeon Alan H. Morris, MD, chair of the Association's Council on Health Policy and Practice, testified before the House Committee on Small Business. "The health care infrastructure of this country has lost sight of ensuring quality patient care and has managed to create a bureaucratic nightmare of paperwork," he said.
"Recent studies have shown that for every hour of patient care delivered there can be 30- to 60 minutes of paperwork," said Dr. Morris.
"HCFA should be required to justify this from a cost-benefit and quality patient care perspective. Our number one concern is the quality of orthopaedic care that we provide to our patients. The growth in Medicare regulations has imposed significant paperwork burdens on physician practices and consumes an enormous amount of time and resources.
"Both the federal government and private insurance providers should be focused on directing resources to ensure an appropriate balance of paperwork to patient care," said Dr. Morris, noting that Medicare health care providers are required to comply with requirements directed centrally from HCFA and independently by the Medicare Carriers.
The AAOS, in proposing the reduction of paperwork, stressed the need to streamline and simplify the forms and reports that must be completed by those being regulated, and to consolidate those forms and reports to avoid unnecessary duplication when several agencies, or entities within agencies, may be requiring similar or overlapping information.
"The AAOS believes that the Paperwork Reduction Act gives the Small Business Committee the authority to address these concerns," said Dr. Morris. "We are concerned that HCFA may be liberally applying exemptions under the Administrative Procedures Act (APA) and other laws to circumvent the review and clearance procedures required to approve regulations effecting paperwork reporting and recordkeeping requirements.
"For example, the evaluation and management (E&M) documentation requirements, among the most onerous paperwork burden in the Medicare program, have never gone through any type of Office of Management and Budget (OMB) clearance process," he said.
According to the Association, forms and data collection requirements initiated by Medicare Carriers should be subject to review by the Office of Information and Regulatory Affairs in the Office of Management and Budget as established by the Paperwork Reduction Act.
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