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AMA, AHA at Odds Over 'Surprise' Medicare Final Rule

Cheryl Clark, for HealthLeaders Media, June 18, 2012

The American Hospital Association and the American Medical Association are at odds over two provisions in a final Medicare rule that give physicians more influence over hospital decisions. And each organization stated its case with heated language in letters to the Centers for Medicare & Medicaid Services.

The AHA likened the new rule to a "surprise switcheroo," while the AMA says that if the AHA, using "very troubling" logic, got its way, "patients would be astonished and appalled to learn" of rules excluding medical staff members from service on the governing body.

The final rule, which specifies how hospitals must meet "Conditions of Participation" in the Medicare program, requires:

  • That a hospital or healthcare system can not have a single integrated medical staff serving more than one hospital, but that each hospital must have its own medical staff.
  • That every hospital's governing board include a member of that hospital's medical staff.

The AHA's June 5 letter says these two new provisions weren't in the Oct. 24 proposed rule. When they were incorporated in the final May 16 rule, it "surprised and greatly concern hospitals and other interested stakeholders." The final rule thus violates the Administrative Practice Act because stakeholders didn't have a chance to object when the proposed rule was open for comments, the AHA says.

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4 comments on "AMA, AHA at Odds Over 'Surprise' Medicare Final Rule"


Kay Bauer (6/19/2012 at 9:17 PM)
To myself as a patient have heard grumbles from a couple of my well respected physicians and I feel there are too many outsiders on hospital boards that really do not grasp the scope of what they are trying to do. I feel we need more physicians overseeing Hospitals as they understand what patients need much more than an outsider on the board. Physicians deal daily with patient illnesses and problems. Patients are starting to get frustrated with hearing these grumblings but I see why after reading this article.

Li (6/19/2012 at 8:38 AM)
First thing that came to mind: I think there will be a lot of educational loans not being paid if the docs can't 'moonlight' at different hospitals the way they do.

SteveA (6/18/2012 at 7:30 PM)
So if a multi-hospital system keeps a single governing board, but must have individual medical staffs, that would mean each hospital gets to send one doctor to the governing board. Imagine that - gasp ! - there would be local physician representation on the governing board ! Does anyone know whether it would be the medical staff who gets to select whom to send, or would the governing board get to pick the doctor they want? - A huge difference between those two scenarios.