Hospital Groups Lobby Against Expansion of Medicare Audit Program

Is the audit program soliciting better health care or justification for non payment to hospitals? 17 million in over payments, 14 million in underpayments...is the program worth 3 million a year? Supposedly they are paid on how much they save the government...is this better healthcare or just another way to cut costs...nobody wants to pay the healthcare bill....BD

Don May, vice president for policy at the American Hospital Association, said, "Any kind of question is a reason for denial," even in subjective decisions such as determining medical necessity. May added, "Going at it from this kind of perspective really isn't, I don't believe, in the best interest of taxpayers."

Hospital groups also say that the program does not allow providers to fix errors, that many claims reviews were not conducted by qualified medical personnel and that auditors have not been required to publicize what areas they are targeting. Don May, vice president for policy at the American Hospital Association, said, "Any kind of question is a reason for denial," even in subjective decisions such as determining medical necessity. May added, "Going at it from this kind of perspective really isn't, I don't believe, in the best interest of taxpayers."