Certainly the blame is with Medicare but in reality, a doctor makes that decision and they are people, too. I suppose I could say it's “who you know”, the personal connection you have to your doctor. Plus, the doctor wants to be paid and he knows the hospital wants to be paid. What he puts on the chart decides where the medical bills go.
Our doctor, who had a personal relationship with my dying husband, kept him in the hospital rather than ship him to hospice where they would have let him die right then. When I asked him not to send him to hospice, he said, “I would never do that to him.” He wrote whatever he had to in order to keep him in that hospital and prolong his life.
The doctor no longer makes the decision it is u to Medicare guidelines the hospitals hire utilization review people to be sure correct status is assigned I am a Hospitalist I know how this works I fight it every day.....
It’s a nice sentiment and one can fudge for a day or two but all charts are reviewed by the insurance companies on an ongoing basis if I could just do what I wanted believe me I would make almost everyone inpatient the reality is that is not possible
Let me stat I am a physician. Medicare is the one who makes this decision. It is NOT the doctors decision. Every chart is reviewed by .gov bean counters. To LIE is fraud. If a physician gets caught padding the records for a “good “friend” that may very well be the end of their career and possible jail time.