As I type this, I am in a semi-famous fast food restaurant in the middle of an extended road trip.

It started last Monday, September 17^th, as I was fortunate enough to be a presenter at the 13^th Annual Coding, Billing and Practice Management Symposium that was presented by the Wisconsin Medical Society. As those who were not in attendance could probably guess, the subject of my presentation was current government audit trends. There were some surprised looks among the attendees of my session, but I left a presentation of this type feeling that finally, the message was getting through to the physician population that complacency is not an option. As with past visits to this yearly pilgrimage to the Wisconsin Dells (complete with time on the water slides; I have a 6-year-old-son, but I only use that as an excuse as I’m a sucker for amusement parks), the experience was fantastic, and the sidebar conversations during the conference were fascinating.

This was followed by vacation. I traveled for 12 hours by car to my friend Steve’s home in Marietta, Georgia to complete the recording of an album I began work on back in February. I am happy to report that it is complete and awaits packaging and “wide” release. The music contained within won’t be to everyone’s taste, but I can assure those interested in purchasing the finished product that it will contain enough material to kill 37 minutes that you may have available.

After arriving back home on the 24^th, I immediately returned to the road for three days of visits to an undisclosed client in a similarly undisclosed location. I have learned two things during these past three days: first, that extended hotel residency is an acquired taste, and that you have to be out of your freaking mind to believe anything that is reported on any cable news outlet, particularly in a presidential campaign season in the United States. Never in my life have I so longed to break out my DVD collection of episodes of Quincy, M. E. Yes, I hear you all snickering, and I don’t care, for Jack Klugman rocks!

While I was away, I was rather unsurprised to see that the Health and Human Services Secretary and the Justice Department issued a joint letter to the heads of five healthcare associations stating that “EHR fraud will not be tolerated”. We are probably all familiar with the scene in Ghostbusters where Dan Ackroyd’s character has a random thought and inadvertently chooses a giant marshmallow man as “the method of destruction”. Thanks to the current healthcare landscape, it appears that physicians have selected their electronic medical record system as their particular method.

Like many in this industry, I have grown tired of CMS, in concert with the remainder of the Executive Branch of our government, continually resorting to strong-arm tactics when it comes to the billing of services, rather than attempting to educate the provider community in a meaningful way as to what constitutes a “tolerable” way of doing things. In the world of CMS, there appears to be no such approach as “the carrot and the stick”, but rather an approach akin to “the stick and the 42-ounce Louisville Slugger utilized by Babe Ruth”.

Here’s a relevant example of what I just mentioned. The Medicaid Integrity Program was designed to be threefold, with different contractors (or “MICs”) handling different portions of the program. The review MICs pick the audit sample, the Audit MICs audit from the selected sample, and the Education MICs are supposed to provide outreach to the provider community based on audit findings. To date, I am hard-pressed to find any evidence that the Education MICs have addressed their task order in any meaningful way. Instead, the provider community gets audited, old revenue is forfeited, and the band on the Titanic plays on.

I can tolerate a lot of things, such as fast food on a Thursday afternoon, or cable news commentary or even a 12-hour drive to Georgia in the middle of the night undertaken for the purpose of singing. What I am having a harder time stomaching is an audit approach that stems from the need to punish, rather than the need to improve. As the need for TUMS sinks in from the roast beef sandwich I just consumed, I can promise the reader that I’ll continue to help physicians fight the good fight against this audit environment, but much like my time away from home, no one road goes on forever.