The American Hospital Association said this morning that it is suing the Federal government over “second-guessed” treatment plans prescribed by doctors and covered by Medicare.
The AHA claims that third-party “recovery audit contractors” are combing through claims looking to deny payment for in-patient services that contractors say could have been dealt with by a physician in an office setting.
Rich Umbdenstock, AHA president and CEO, said, “Doctors and nurses provide the best care possible using their medical judgment and training. Allowing government auditors to second-guess these difficult medical decisions about where to best treat a patient years later based on a cold record and then refuse to pay for that care is indefensible.”
For a more complete picture of the situation and the Federal government’s take on the situation, please read Modern Healthcare’s article here.