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

Cheryl Clark, for HealthLeaders Media, June 18, 2012

Single, separate medical staff
AHA president and CEO Rich Umbdenstock's letter accused CMS officials of pulling "a surprising and impermissible about-face" in requiring that each hospital, regardless of whether it is a part of a multi-hospital system, have a single and separate medical staff. He likened it to "a surprise switcheroo."

Umbdenstock says that such language was not in the proposed rule, and in fact, the proposed rule mentioned "that some systems had unified their governing boards. The only possible interpretation of this section ...is that CMS concluded that its language permits a unified medical staff, and it was not proposing to change that."

If in its proposed rule CMS had indicated it was considering such a change, "the affected stakeholders would have described the enhanced ability of their medical staffs, working as a unified body, to more effectively and efficiently review, credential and privilege individuals seeking staff privileges."

Having one medical staff serving a whole health system would be more effective in standardizing high quality and safe care, address knowledge gaps, "before patient care suffers." In fact, many health systems have already unified their medical staffs by adopting medical staff by-laws, policies and procedures.

But James Madara, MD, AMA executive vice president, says his organization "strongly supports" the rule. 

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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.