A somewhat straighter PATH: this troubled Medicare audit program has been improved, but more changes are needed for it to operate fairly

Article Abstract:

Changes that the Medicare administration has made in its Physicians at Teaching Hospitals (PATH) audit program have improved that program's flaws, but more changes must still be made. The PATH audit program retroactively applied Health Care Financing Administration payment and coding rules that came out in 1995 and 1996 to payments made during 1990 through 1996. Sixteen of the 49 PATH programs targeted for audit have been spared costly and inappropriate audits; however, the Dept of Health and Human Services must correct other problems with the program.

Editorial, Health care industry, United States. Centers for Medicare and Medicaid Services

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Protests prompt HHS to retool PATH audits of teaching doctors

Article Abstract:

The US Department of Health and Human Services has introduced new guidelines for audits of the Physicians at Teaching Hospitals program. This change was prompted by physician complaints concerning the Medicare fraud investigation of teaching hospital physicians. The American Medical Assn and the Assn of American Medical Colleges believe the billing errors found in the audit were caused by poor communication and contradictory policies rather than fraud on the part of teaching hospital physicians.

Police Protection, Fraud, Standards, Investigations, Medicare fraud

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AMA: stop PATH audits

Article Abstract:

The Assn of American Medical Colleges and the American Medical Assn will soon file a lawsuit against the federal government because of nationwide audits of Medicare Part B physician billing at teaching hospitals. This dispute over the controversial reimbursement policies has been ongoing between academic physicians/hospitals and the government. The audits focus on 1990-96 billing.

Professional Organizations, Medical Associations, Cases, American Medical Association, Trade and professional associations, Professional associations, Trade associations, Medical societies, Association of American Medical Colleges

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