Sunday, November 25, 2012

Back in Action: the morass that is Obamacare

I have been listening to physicians complain about the Affordable Care Act for several months now.

Last week a physician orthopedic clinic told me that they are mandated to check blood pressures on every visit, even if it is not (". . . and 99% of the time, it's not," the Orthopedic surgeon told me) medically necessary or even relevant.  Orthopedic doctors have applied for a waiver, but are not optimistic.

Another physician told me, two weeks ago, about the nightmare that is the compliance requirement for Electronic Medical Records, where "one size is required to fit all," and the same questions must be asked of every patient, and those results MUST be reported to the Federal government.

Do you smoke?  MUST be reported to the Feds.

Have you ever used marijuana?  MUST be reported to the Feds.

Ever suffered from depression?  MUST be reported to the Feds.

Are you pregnant?  If you are a 17-year-old female, this MUST be reported by the doctor to the Feds, even though s/he is not allowed to report it to your parents.

But the crowning glory is this:  at your "free" annual physical, you MAY NOT discuss any new ailment with your doctor: 

I have now posted a notice in my office and each exam room stating exactly what Obamacare will cover for those yearly visits. Remember Obama promised this as a free exam — no co-pay, no deductible, no charge. That’s fine and dandy if you are healthy and have no complaints. However, we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code —
insurance will not cover any new ailment under that code.
If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.
You, the patient, will then have to make a decision.
Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss.
Can't wait to see how many more new surprises are out there. . . . 

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