It's a day early, but it's basically 4th of July weekend. I don't know if kids learn what the 4th of July means anymore, but to me it was huge, the birth of the nation, freedom, no more tyranny from the English king. I still see it like that. A nation's birthday, a national holiday that is imprinted in all Americans' hearts. Who can forget the Cool Whip and berry pies, the lemonade, the grills firing up. The older I get, the more nostalgic I become thinking of the picnics, summer parades, fireworks-- I especially remember the HUGE national party in 1976. I was 8 years old and we lived in an apartment complex on the New Jersey side of the Hudson River, and from our balcony I remember seeing the masted ships and colonial-era reproductions sailing down the river. I remember the fireworks at night. I remember president Carter speaking, and I remember mostly the pervasive sense of hope. We were touching the past but also touching the future, with hope and excitement for the our country, the greatest nation--"200 years old and she's just a baby" went the jingle on the radio. I remember the hot sun and how freeing it felt to run through sprinklers, and that our playground had all the mommies gather on benches to chit chat while watching us kids play. No fears nor smartphones. No posing for selfies nor tattoos. I'm an old fart now and I'm going to kvetch. There were social rules and we (mostly) followed them. We wanted to be great and strong and free. As an 8 year old I was immune to whatever national problems were simmering. Backbiting and stabbing were certainly going on but my childish view didn't include that. Fresh from Watergate, Vietnam, assassinations and civil unrest, it seems like in 1976 we took a collective sigh and let it all out.
That was 40 years ago. Today I feel something very different.
I hear daily lamentations from my patients. They're fearful, unsure, angry. They've been lied to. I'm often the bearer of bad news and in general they're kind about it and don't lash out at me personally. I'm not talking about the medical bad news. It's financial bad news. Every medical person/clinic/establishment has to analyze, digest and deliver t to the patient what the insurance plan covers, or not. What the annual deductible is, and how much of it they've used up or how much they owe. What the preauthorization yielded, or what the denial was about. The rules change mid game, or to use a football analogy, the rules change in mid air from the time the quarterback makes a pass to the time the ball lands---in the mid-air trajectory, the rules of game changed.
How the hell can we work in a situation where the rules are changing, unknowable, so fluid that we never know what's actually in force much less what's going to happen?
Hence the anxiety. I try very hard to find outlets for my own anxiety, but believe me it's there. So many of my patients are taking prescribed daily benzodiazepines because they're not sleeping, they're not eating, they're truly at the end of their rope. Unemployment, illness, the inability to meet medical costs and bills despite the promises, despite the "Affordable" being right there in the title of the law. I see desperate eyes every day.
Nobody has a crystal ball. The unknown is always there, just ahead, that's the blessing and the curse. Would it be any better to know what exactly is coming down the path? No. But the hourly bad news and the harsh reality of a stagnant economy, of lack of opportunities, and of wounded Iraq war veterans coming home to commit suicide has stained my community. I feel that America is at a breaking point, people are more nervous, anxious, and fearful than I've ever experienced.
I pray that this long weekend we can all take a collective sigh, and in a small way shift our thoughts to the patriots who founded our nation. They were anxious, unsure, putting everything on the line--their lives and livelihoods, their families. All for the dream of freedom. We must still hold on to that dream. We are free. We must embrace that feeling and apply it, defend it daily when it's under assault, call on the little dictators in our lives and tell them they're causing individuals--and the nation-- harm.
Below is an example of the Medicare e-newsletter, today's edition. It's rife with warnings, alphabet soup programs and rules that I have no clue about. To fully comply with this would take days to decipher what each program refers to and how to implement the rules. In this spirit, I would say, reclaim our freedom from the impostors in government. We cannot live life in a Kafkaesque tunnel with no way out. Whatever you may think of whatever political party, they have all lost touch with the people of the nation and have trampled on them with unabated tyranny. We must remember that we are the ones who consented to be tyrannized. And we are the ones who must put a stop to it.
"Be bold, and great forces will come to your aid"--Goethe
May you all have a blessed and healthy
4th of July!!!
In this Edition:
News & Announcements
- ESRD and DMEPOS: Proposed Updates to CY 2017 Policies and Payment Rates
- Home Health Agencies: Proposed Payment Changes for CY 2017
- July 2016 DMEPOS Fee Schedules Available
- Moratoria Provider Services and Utilization Data Tool
- EHR Incentive Program: Hardship Exception Applications Due by July 1
- CMS to Release a CBR on Physician Assistant Use of Modifier 25 in July
- Updated Inpatient and Outpatient Data Available
Claims, Pricers & Codes
- 2017 ICD-10-CM and ICD-10-PCS Files Available
Upcoming Events
- Clinical Diagnostic Laboratory Test Payment System Final Rule Call — July 6
- DMEPOS Competitive Bidding Program Round 2 Recompete Webinars — July 7 and 12
- Quality Measures and the IMPACT Act Call — July 7
- SNF Quality Reporting Program Call — July 12
- Comparative Billing Report on Diabetic Testing Supplies Webinar — July 27
Medicare Learning Network® Publications & Multimedia
- Medicare Coverage of Diagnostic Testing for Zika Virus MLN Matters® Article — New
- Recovering Overpayments from Providers Who Share TINs MLN Matters Article — New
- Implementation of Section 2 of the PAMPA MLN Matters Article — New
- Physician Compare Call: Audio Recording and Transcript — New
- SBIRT Services Fact Sheet — Reminder
- Remittance Advice Resources and FAQs Fact Sheet — Reminder
