Law of Unintended Consequences Strikes Obamacare

by Admin on February 8, 2013 · 0 comments

in Medicare, News, Patients, Payers, Providers

English: Barack Obama signing the Patient Prot... English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

Well, the Affordable Care Act has already kicked in. And the law of unintended consequences is again running amok. Beware if you are on Medicare or Medicaid, and even several private plans:

Because I have mitral valve prolapse (benign abnormality) I go every couple of years to the cardiologist to have it checked. When I go, I get a nuclear treadmill test (standard of care for diagnosing heart disease in women), an echocardiogram (standard of care for diagnosing abnormal valve actions) and a visit with the doctor to discuss the results.

In the past, all of that took place on the same day. This year, however, because of changes in the insurance policies of the federal government, I had a chat with the doctor, and made three other appointments — one for each test and one to discuss the results.

This time the treadmill test was without contrast materials.

I took time off four times, waited in his office four times, traveled four times, and waited four weeks. One long-time treadmill tech finally explained it to me. According to the new regulations, the doctor can’t get paid for a visit if you have a test the same day. And the insurance will not reimburse for two tests given on the same day. Moreover, you don’t get a contrast treadmill anymore, except as a followup to a standard treadmill. If  they had discovered anything wrong, I would have had to make another appointment to have the treadmill with the contrast.

How does this save anyone any money? Was is supposed to prevent waste and fraud?  The staff has to submit four or five different claims. The office has to squeeze in the same patient load, spread over more time.  More gowns, more techs, more claims processors. The doctor can’t make a timely diagnosis. And I waste time and gas.

Of all the new rules that I know about, this is by far the stupidest. If anyone can tell me the reason for it, or if anyone has seen stupider rules, let me know below. I’m disgusted. If this is reform, I’m sorry I fought for it.

 

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