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Urge HHS Secretary Kathleen Sebelius to Make ABC Codes an Option Under HIPAA

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Although the United States trails the other industrialized nations in measures of longevity and quality of life, we currently pay more than double for healthcare per person compared with Canada, the country closest to us in rankings of healthcare costs.

Medical mistakes, prescription errors, missed diagnoses, hospital-acquired infections and negative side effects of properly prescribed medications: These waste all too many dollars as well as adversely impacting patient care. Studies show that 93 percent of U.S. physicians practice defensive medicine, ordering tests and procedures with no other purpose than to forestall potential litigation. As pointed out in the Wellness Resolution supported by ANH-USA in its September 23, 2008 appeal, we must embrace a new vision if we are to reform healthcare in the United States.
At a recent gathering of the National Foundation for Women Legislators, where access to healthcare was the prevailing issue, NFWL’s Healthcare and Empowerment Policy Committee stated that over 75 percent of healthcare services in the United States are rendered for nonacute conditions. The committee also noted the gaps in provision of primary care in 6,525 medically underserved areas of the country. Meanwhile, state budgets face a crisis caused by accelerating costs related to Medicaid and other programs that reimburse healthcare expenses.
In formulating answers to these problems, NFWL’s Healthcare and Empowerment Policy Committee (HEPC) noted that the United States has about 2 million healthcare providers who, although not conventional doctors, are legally authorized to treat patients’ nonacute conditions without the oversight of an M.D. These providers include acupuncturists, advanced practice nurses, behavioral health providers, chiropractors, dieticians, holistic physicians, massage therapists, midwives, naturopathic doctors, nutritionists, pharmacists, and physical and occupational therapists. Not only does access to these providers typically cost less, it also reduces overall charges for physician oversight. HEPC, therefore, supports informed consumer-choice and autonomy for physicians and dentists in using all conventional, complementary and alternative treatments that may aid the patient’s recovery.
HEPC  — which urges both the federal and state governments to ensure that the law reflects informed consumer-choice — has identified the ABC coding system as the most cost-effective solution. The ABC system processes electronic insurance claims and payments from non-M.D. professionals. Designed to be compatible with the existing CPT/ICD claims-filing system, ABC has been employed successfully in over 2 million claim transactions at a cost benefit of 50 percent. NFWL asks that ABC codes be made available to any willing healthcare-providing entity in order to process insurance claims more efficiently.

As the former House Speaker Newt Gingrich stated in his book Savings Lives, Saving Money, it’s critical that we consider solutions outside the current box. Urge Secretary of Health and Human Services Kathleen Sebelius to take the first step by embracing patients’ access to nonacute care by the nation’s 2 million qualified non-M.D. providers.

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