Physicians Practice - September 2008 - (Page 46) ASK THE EXPERTS A There is no national regulation or law that requires anyone to have an EMR. There are many legislators saying it is a good idea, but there’s nada on the books. DME STARK EXCEPTION Q This issue keeps coming back on my radar screen: As a primary-care practice, we don’t have much DME that we give our patients, but we do provide crutches, neck, wrist, elbow, and ankle bracing, heel cups, and the like, and then bill the patient’s insurance accordingly. We have relatively few Medicare patients. When our Medicare patients fall, we usually recommend they go to the ER because of the likelihood of broken bones and other complications. So, giving DME to a Medicare patient is an infrequent occurrence around here. Up to this point, I’ve been assured that these kinds of DME are excluded from the phase III rule of Stark, as they are needed to assure that the patient can safely leave our practice. Do you agree that there are some “small DME” items that primary-care practices can still provide to Medicare patients while staying within the law? A Yes, there is an exception for ambulatory infusion pumps, blood glucose monitors, and a few other ambulatory devices necessary for the patient to be able to leave the office, such as crutches, canes, walkers, folding manual wheelchairs, etc. See page 79 of www.bricker.com/ LegalServices/Practice/HCare/laws /cms090507.pdf. USING FOREIGN DRUGS Q Am I legally able to use a drug product manufactured abroad? Have there been any prosecutions and/or sanctions implemented to date? If I can purchase products at a discount and be assured of the source and the “equal” quality of the product so the only difference is the labeling, I would like to do so. I do not care what people think; I care about treating patients as safely and efficiently as possible. For too long the medical profession has let the lawyers screw with us. If there is no state or law, then we (medical practices) should tell them to stop with the rhetoric. A It is illegal to import drugs. Here is a summary of the legal and regulatory territory: kuhl.house.gov/ UploadedFiles/prescripdrug imports.pdf Now, as to whether anybody will come after you, I don’t know. But I should think you’d want to take FDA claims that foreign drugs may not meet safety requirements seriously. Heaven knows the FDA has its problems, but there is no other way to know about the safety of a given product or how it has been stored or transported. SAMPLE CONTRACT CANCELLATION LETTER Q Do you have an IPA termination letter sample? We want to write a letter to an HMO that we will no longer be contracting with them. For legal purposes, we do not know what is important to mention. 46 | PHYSICIANS PRACTICE | SEPTEMBER 2008 WWW.PHYSICIANSPRACTICE.COM http://www.bricker.com/LegalServices/Practice/HCare/laws/cms090507.pdf http://www.bricker.com/LegalServices/Practice/HCare/laws/cms090507.pdf http://www.bricker.com/LegalServices/Practice/HCare/laws/cms090507.pdf http://kuhl.house.gov/UploadedFiles/prescripdrugimports.pdf http://kuhl.house.gov/UploadedFiles/prescripdrugimports.pdf http://kuhl.house.gov/UploadedFiles/prescripdrugimports.pdf http://www.amt1.com http://www.amt1.com http://WWW.PHYSICIANSPRACTICE.COM
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