Keep on top of this issue
Keep your staff informed so the change doesn’t take them by surprise. "Most ED physicians don’t know much about this, so ED managers need to get the word out that this is coming. Inform staff and hospital administrators about the potential ramifications of this," urges Bishop. (See story on concerns for emergency medicine, p. 89, and ACEP’s commentary, p. 91.)
Also, keep abreast of new developments, Yeh recommends. "ED managers should stay in touch with hospital administrators and work with trade associations like the American Hospital Association [AHA] and the American College of Emergency Physicians to make sure our voices are heard."
Many ED managers are unprepared for this change, says Smith. "It is a sleeping issue because it’s been expected for so long and has been put off so many times," he explains. Implementation originally was scheduled for January 1, 1999, but the date has been moved to April 2000.
A draft of the proposed regulations was published by HCFA, and comments on the preliminary rules are being reviewed, notes Smith. The final rules will be published 90 days before implementation. The delay is due to HCFA’s problems with the Y2K computer bug.
"Hospitals will need the intervening months to prepare for the operational changes required for billing of outpatient services and to plan their response to the market changes that the new Medicare payment system is certain to cause," says Smith.
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