[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H. Con. Res. 264 Introduced in House (IH)]







105th CONGRESS
  2d Session
H. CON. RES. 264

  Expressing the sense of the Congress with respect to documentation 
 requirements for physicians who submit claims to Medicare for office 
        visits and for other evaluation and management services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 28, 1998

 Mr. Pallone (for himself, Mr. Pascrell, Mr. Sandlin, Mrs. Cubin, Mr. 
  Kleczka, Mr. Weldon of Pennsylvania, and Mr. Rothman) submitted the 
following concurrent resolution; which was referred to the Committee on 
                             Ways and Means

_______________________________________________________________________

                         CONCURRENT RESOLUTION


 
  Expressing the sense of the Congress with respect to documentation 
 requirements for physicians who submit claims to Medicare for office 
        visits and for other evaluation and management services.

Whereas adequate documentation is necessary to assure quality and 
        appropriateness of services;
Whereas effective strategies to eliminate waste, fraud, and abuse in the 
        Medicare program should not result in excessive documentation 
        requirements being imposed on physicians that will interfere with 
        patient care;
Whereas if the documentation in the medical record does not meet program 
        requirements, payments for such claims may be denied and an 
        investigation into potential fraud and abuse may result;
Whereas the administrative complexity of the documentation requirements may 
        increase the risk that physicians will make inadvertent coding errors; 
        and
Whereas inadvertent errors or legitimate differences of opinion on coding and 
        documentation of physician services under current law are not grounds 
        for concluding that fraud has occurred: Now, therefore, be it
    Resolved by the House of Representatives (the Senate concurring), 
That it is the sense of the Congress that the Health Care Financing 
Administration should--
            (1) further postpone its plans to implement the 
        documentation guidelines for evaluation and management 
        services, as currently constituted;
            (2) continue consultation with organizations representing 
        physicians on how to reduce the complexity of any such 
        guidelines prior to their use by Medicare or its agents in 
        review of claims submitted to the program;
            (3) conduct a pilot study of any such documentation 
        requirements prior to use in audits and other review 
        activities; and
            (4) assure that any such documentation guidelines, if 
        applied by Medicare or its agents in review activities, 
        contribute to quality care and do not detract from good patient 
        care by requiring physicians to spend undue time documenting 
        their services--at the expense of spending less time with 
        patients--or lead to sanctions being imposed for unintentional 
        coding and documentation errors.
                                 <all>