TACOMA, WA – Stipulations released last month by the Center for Medicare Services have added on to the already onerous documentation requirements necessary for reimbursement. In a shocking twist, CMS has dictated that doctors now must literally jump through a hoop before they can submit claims to CMS.
“This is craziness,” said Dr. Bro Duderson, an ER attending at Saint Joseph’s hospital in Tacoma, Washington. The CMS hoop has been in his billing department for a month now. Plans to make it have flames had to be scaled back due to OSHA concerns.
“It was bad enough when we had to order blood cultures on every pneumonia or write that patients may have prehypertension when their BP is 122/81. Now I have to jump through a two-foot hoop that’s chest-high from the ground. If we use a springboard to get momentum, CMS knocks our pay down to 80%.”
Dr. Duderson states he has jumped through the hoop after dutifully charting pre-hypertension or poorly-controlled hypertension in patients with long bone fractures, anxiety attacks, and those high on stimulants like cocaine and methamphetamine. Reports that these patients may have taken their hypertension discharge instructions and rolled them up to smoke crack through could not be confirmed at time of press.
The hoop regulation is causing new challenges to the practice of medicine. Dr. Duderson has had to step in as interim director of the ED. This occurred when the elderly former director, Dr. Jack Jockley, broke his forearm attempting to clear the hoop to seek reimbursement for a homeless man’s ninth visit that month with chronic foot pain. His injury was attributed to “a weak-a** takeoff” by multiple witnesses.
Dr. Jockley was seen in his own ER and diagnosed with a compound left radius fracture and “bizarre personal appearance” because of his use of a bowtie. Due to a discharge BP of 128/81, he was advised to follow up for evaluation of his prehypertension.