• Gregory R. Piche'
    3144 Newton Street
    Denver, CO 80211

Areas of Practice

  • Healthcare Consulting
    Peer Review Proceedings
    Hospital/Physician Relationships
    Medicare/Medicaid Audits




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Richard Willner


A few days ago, every doctor who called me wanted to know how he will survive with a 60 percent cut in pay ( 30 percent Medicare cut with 50% overhead). I told them that I would not discriminate against Medicare patients vs others as this might be a real problem. I told them that normally I would bet that the "doc fix" would come later than sooner but that was before the 70 Billion was extracted from Medicare. Maybe the government can borrow more money from the Federal Reserve or just print it. I told each to consult with a competent Health Care lawyer before doing anything. It is way too easy to get into the Anti-kickback or Stark Zone.

I would bet that ultimately, the State Board will link acceptance of Medicare and Medicaid to one's License. I know that this is a problem, but if the bankruptcy laws can suddenly change in the GM bailout, all things are now possible.

I think that the regulators forget that there are only one class of people who are licensed to diagnose and treat Americans and they are being pounded to death.

Richard Willner
Center for Peer Review Justice


Thank you Richard.

Richard Willner


So a doctor uses EHR and does exactly what the Feds want. The chart note instead of being a summary of positive and negative findings written in short-hand and easily understood by any other doctor, becomes pages of crap with the important findings hidden. Also, once the chart is digitized, it is impossible to keep private like a paper chart locked in a doctor's office. The argument that digital records can easily be shared by other doctors sounds great in theory but I remember when the doctors in a community would routinely share their charts with each other by fax. Very quick. Very efficient. Great quality of care.

Regarding "upcoding" secondary to the complete progress note, wasn't the goal to have "complete" medical records?

What does it really matter? Medicare announced it's 28% reduction as it does every year. But, this year is different as significant money was taken from Medicare and we are heading towards nationalization of health care.

However Medicare does this "doc fix", reimbursements for each CPT code will be dramatically decreased. If the goal is "quality of care", how is this goal met when every doctor in private practice that I talk to tells me that they can not continue to practice?

It takes more than a decade to grow a doctor. This is an effort of one's complete time and focus. It would seem to be cost effective to KEEP those doctors in practice rather than to run them off.

Richard Willner

PS: Great blog !!

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