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American Hospital Association And Medicare Bill Term Paper

¶ … American Hospital Association (AHA) might be interested in the pending legislation: Although all three positions of the proposed bill would be of concern, two of the three would cause serious ramifications for the AHA and its members. The first would be the 5% annual reduction. This cut equates to a very serious amount of income for the industry especially if the cut was scheduled for across the board reductions. Hospitals and nursing homes are already working at bare bones and more cuts would cause serious financial dilemmas if implemented. If the cuts are unique to certain aspects of the Medicare billing system, the AHA would need clear details of where the proposed cuts would actually be coming from.

The second of the three major concerns would be the simplification for assessing penalties to providers accused of abusing the Medicare payment system. It is the AHA's stance that providers should still be first considered innocent until proven guilty. But these proposed regulation changes do not take into consideration that it has been clearly demonstrated that often what has been construed as Medicare fraud can actually be unintentional mistakes due to the difficult Medicare documentation process.

2. Make a statement AHA would make regarding this issue:

We are pleased that the Medicare legislation process is doing its...

Examples include: Local, State and Fiscal intermediaries, private and semi-private insurance companies and other companies that process claims, private corporations and industry representatives that do their own claims, Unions and the obviously the Medicare offices themselves. Couple that with a billing system that has many bottleneck paperwork points, completely confusing regulations with many contradictory instructions and other inert problems and it is a wonder more errors that could be construed as abuse do not occur. It is the AHA's position that rather than spending money on prosecuting unsubstantiated abuse claims or reducing provider funding, it would be better for this proposed legislation to address the existing Health Care Financing Administration (HCFA) so as to create a viable alternative to the existing convoluted billing regulations. There are many potential savings in greater amounts than…

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