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

Cheryl Clark, 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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