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

Cheryl Clark, for HealthLeaders Media, June 18, 2012

The AMA's June 13 letter says "some hospital groups are attempting to force changes to the governing body and medical staff provisions of the final rule" and working to make those changes through revisions in interpretive guidelines.  "We strongly urge CMS to ensure that this process is transparent and does not contravene the provisions of the final rule"

The AMA, however, says the language was written in the proposed rule and "in fact, many stakeholders discussed the issue of a single medical staff in their comments on the proposal."

Cecil Wilson, MD, the AMA's immediate past president, says that "if you do not have on a hospital governing board "a physician who can help make decisions related to quality and safety, I think the possibility and risk of making decisions which are not well-informed increases. Not to have that  (input) would put these boards at risk of making decisions, which were not in the best interests of the hospital or for the patients."

CMS officials say they are caught in the middle. "We're aware of the concerns around this rule and are taking them seriously," CMS spokesman Brian Cook wrote in an e-mail. "We are looking at how to avoid any unnecessary conflicts for facilities, while also allowing medical staff’s perspective on quality of care to be heard by an organization's governing board."

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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.