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Invite a local Medicare official to address district branch member concerns, and you are likely to draw a crowd, according to Renée Binder, M.D., president of the Northern California Psychiatric Society (NCPS).
"The January 7 council meeting in San Francisco was packed with over 90 psychiatrists in the room," she said in an interview with Psychiatric News. "Usually, about 20 members show up at these meetings."
The featured speaker was Gerald Rogan, M.D., medical director of the Northern California Medicare intermediary (the National Heritage Insurance Company). He was joined by his assistant and Medicare ombudsman, Dennis Graham. They responded to 22 prepared questions and concerns about Medicare rules. Members also asked questions from the floor.
This was the second council meeting with Rogan organized by the NCPS Psychiatric Practice Committee and Executive Committee in an effort to clarify and discuss ongoing Medicare issues. The first meeting was held last April.
District branch members have continued to complain that Medicare is still denying payment for psychotherapy and other services and has been overly intrusive in requesting chart notes, Binder commented.
Thus, the first question Rogan was asked at the meeting was, What is the initial number of psychotherapy visits allowed without review?
He responded that every visit needs to be medically necessary and reasonable, but federal regulations prohibited him from disclosing the specific number of visits that can occur before a review, according to Binder's follow-up report.
"We explained to Rogan that this was unacceptable because it is essential to discuss the number of visits with the patient in terms of delineating a therapeutic contract with reasonable goals," said Binder.
Rogan apparently left the meeting impressed with what he had heard because the next day he told members of the Psychiatric Practice Committee that he wanted to discuss whether 28 approved psychotherapy visits for certain diagnoses seemed reasonable, Binder commented.
The meeting has led to many positive initiatives. Rogan has submitted proposals to NCPS regarding reasonable Medicare policies and contributed a column for the March 8 district branch newsletter.
Several NCPS members have begun drafting a form to justify treatment visits instead of requiring psychiatrists to hand over chart notes, Binder said.
"This meeting demonstrated the power psychiatrists have when they present a united front. By joining together, we can change policies and influence rules and regulations that are damaging to patient care."
Several NCPS members also expressed their appreciation to NCPS officers for organizing such a meeting. "Some members have told us they are no longer ambivalent about the value of their NCPS membership," said Binder.
Several factors contributed to the council meeting's success, including soliciting questions from members and submitting them to Rogan in advance of the meeting, mailing event flyers to members, and providing an inexpensive dinner.