Medicare changes create problems

Over the next two years, the Affordable Healthcare Act, or many elements thereof, will likely be rolled out. Some features are already being used. There are also changes coming to Medicare and some changes are causing physicians to opt out, myself included.

Opting out means the physician may not bill Medicare for services but receives payment, at time of services, from the patient. Then the patient files the claim with Medicare. This frees the doctor to manage the details of the practice as is deemed best.

Two changes to Medicare make it difficult for solo physicians to continue to participate in Medicare.

The first is Medicare’s insistence that the clinical medical record (doctor’s notes), not just the processing of claims, be computerized.

The primary reason a small practice can not comply with this mandate is the cost of implementing and continued operation of the system.

There is also the very real concern of privacy and security. Consider South Carolina’s debacle with the hacking of the state’s Department of Revenue’s computer.

Medicare is also forcing (without exception) physicians to accept payment electronically. That sounds secure and convenient, but it also permits Medicare to withdraw funds automatically for overpayments or just by error on the part of Medicare.

At your next visit, if your physician is tapping away at a laptop, just ponder how secure that system is. Then request that your prescriptions and diagnosis not be entered.

It’s one thing for your social security number to be accessed, but do you really want to risk your confidential medical record being hacked? ED, VD, PTSD or ADD, this knowledge about you should never be available. For every 256 bit “un-hackable” encryption program, there’s someone developing a 257 bit way to beat it.

Dr. Mike Vasovski