Hearings sought to soften feds’ investigative zeal

Can we have a kinder, gentler’ HCFA?

Pushed by physicians fed up with what they say are harsh tactics by federal investigators and a growing set of egregious reimbursement rules, the American Medical Association and other medical organizations want congressional panels to hold hearings calling the Health Care Financing Administration on the carpet.

Other items providers want to place on the agenda include:

1. HCFA’s decision to reduce AMA-recommended work values for services used to treat critically ill Medicare patients without first seeking public comments;

2. a new rule excluding practice expense payments to physicians who bring their own staffs to hospitals to help treat patients;

3. use of secret, proprietary commercial "black box" edits to detect improperly coded claims.

If the hearings are held, they will be modeled after a recent series of Capitol Hill investigations into how the Internal Revenue Service treats taxpayers. Those hearings convinced the IRS to adopt what has been called a "kinder, gentler" attitude when dealing with taxpayers.

Will the strategy work for HCFA?

While the hearing strategy worked with the IRS, some Washington insiders say trying to duplicate this campaign with HCFA will not fly. First, they say that while every American knows about and tends to resent the IRS, the general public has no idea what HCFA is all about.

Perhaps more importantly, a good government spin doctor can turn even the most honest grievance around to make such hearings sound like a bunch of rich physicians complaining about rules set up to stop unscrupulous provid ers from lining their pockets with increasingly scarce Medicare money at the taxpayers’ expense. That could force physicians to try to prove their innocence, which is very difficult from a public relations perspective.