[Red Badger]

[stephenjohnbanker]

Yeah.............

[driftdiver]

Don’t believe it. CMS hires auditors who are paid by how much they disallow. Then the hospitals appeal and end up getting paid after a long and tortuous battle.

Its a huge and colossal mess but hospitals aren’t the ones making out. Its organizations that sell medical supplies. Take Wellcare here in Tampa. Partly owned by Soros and the Saudis. They previously admitted to massive fraud, paid a small fine and keep on trucken.

[Abby4116]

I think this falls under the same thing as the article I read the other day regarding Medicare inpatient vs observation status. To protect themselves from this, hospitals are often admitting patients for "observation" for 3 days rather than as inpatients since if the auditors determine that the patient did not need to be an inpatient, the medicare payment is taken back from the hospital.

Of course, the out-of-pocket for the Medicare recipient is much different for the two classifications. If only for observation, rather than the Medicare Part A (capping at around $1300 patient co-payment) paying, Medicare Part B pays along with all of their co-pays for each procedure. There is also no nursing home from hospital benefit if under "observation".

The hospitals are caught in a catch-22 as are the Medicare recipients.