Government denying Medicare payments in bid to control your care
Government auditors, not doctors are trying to influence care decisions.
A group of hospitals is suing the federal government over its efforts to dictate where you are treated. The Department of Health and Human Services (HHS) is accused of attempting to make medical judgments that are best left between the patient and doctor.
Using bureaucratic loopholes, auditors are inserting themselves into your medical decisions.
Depending on a wide variety of circumstances, a doctor and patient may agree to treatment within a hospital with a stay as opposed to an outpatient procedure. The HHS is attempting to exercise control over this by withholding Medicare payments to the hospitals.
In their complaint, the AHA says that the HHS is illegally withholding payments from the hospitals after a second-guess auditors decided that a number of procedures should have been treated as outpatient procedures. None of the auditors are physicians.
The HHS is refusing to comment on the litigation because it is active.
The AHA says this is a common occurrence, but it has recently become much worse. They point out that many hospitals find it easier to simply let the HHS have its way and write off the money because litigation is too expensive.
Ultimately, the issue is one of who should best determine care for a patient. Should it be an Obamacare auditor or a doctor working with their patient?
Since the HHS isn't commenting, we have very little information to understand just why they are second-guessing patient-doctor decisions, aside from their rulings.
Unfortunately, if hospitals must fight for their Medicare payments, above and beyond reasonable accountability, it will have a stifling affect on choice and the quality of patient care.
To combat this growing problem, the AHA is supporting legislation that will place restrictions on the HHS ability to deny payment for appropriate services. That legislation will not be debated for several months.
Meanwhile, the creeping control of Obamacare continues.
© 2012, Distributed by NEWS CONSORTIUM.
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Keywords: HHS, AMA, Chicago, medical, care, payments, lawsuit
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