Audit Stings Hospitals

[ivor]

Ya gotta love this:

http://news.yahoo.com/s/ap/20080301/ap_on_go_ot/hospitals_medicare

There's a mega-bureaucracy to give money away and a mega-bureaucracy to take it back.

[Sibling Zono (anon1mat0)]

Nice, 'audit' for us and you get 20% of the reclaimed money. Interesting how this thing is applied to medicare instead of something more juicy like, say, defense contracts.

[Sibling Chatty]

Yep.

Can't disturb the defense contractors, though. The TERRISSTS will win!!

AS to the medical??

Gee, ya think maybe a SINGLE PAYER SYSTEM without the ability to DEFRAUD by multiple (temporally impossible) procedures written in the programming--and competent levels of oversight, rather that having the cheating to cover rejected procedures ("no, they've refused to pay for this, but we'll catch it elsewhere" is not an uncommon statement to a Medicare patient) might work better?

Too much collusion among the for-profits to get the $$ from the government.

Want this crap to be billed honestly? Give each PATIENT/family the ability to review the bills as well.

[The Meromorph]

The Medicare rules, which have the staus of law, were written by Congress. Thus they are the result of negotiations between interest groups, and particularly special interest groups. The rules, which run to many volumes of fine print, are, in fact, self-contradictory, A provider can bill a certain amount and be able to prove, with chapter and verse, that it is an allowable charge. An auditor can almost always find other chapter and verse combinations which would disallow the charge. If a provider bills a charge which they can prove to be valid, but prudently sets aside a reserve in case it is disallowed, this is, and has been in court, considered absolute proof of fraudulent intent!