Medicare Outlier Payments
- Topics:
- Regulatory issues
- Tags:
- Finance,
- Healthcare,
- Medicare,
- Operational Accounting,
- Payment
- Source:
- Jones, Day, Reavis & Pogue
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Overview: This paper discloses that the Medicare outlier payment system contains recognized weaknesses. Although HCFA/CMS as been put on notice of these regulatory flaws since it promulgated the outlier regulations in 1988, it has not taken any action to revise outlier payment policies. Hospitals should exercise caution, however, before following the advice of consultants to increase charges to obtain greater outlier payments. Experience over the past decade has shown that the government often treats providers who benefit from defects in the Medicare program as having defrauded Medicare. The government all too often fails to implement a regulatory solution at the time that problems with the Medicare regulations are raised, and then later accuses providers of fraud. This history could repeat itself in the context of Medicare outliers. Read to know more about the concept deduced in the article.
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Format: PDF | Size: 50KB | Date: Nov 2002 | Pages: 3
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