Friday, January 11, 2013


The Affordable Healthcare Act (ObamaCare) is so full of terror that soon Homeland Security will declare it unsafe to fly.

Well, at least we could hope so.

Health care revenue cycle expert, David Catron, has written about an issue that has been a part of Medicare for decades. Under ObamaCare it will only get worse, as the AHA exacerbates its excesses.

Writes Mr. Catron:
“When I began writing about the menace of increased federal involvement in our medical delivery system, I was surprised to discover that some doctors actually supported it. These misguided medicos represented only a small minority of practicing physicians, and most were profoundly ignorant about health care economics, but the “M.D.” following their names provided them with a fa├žade of credibility.

“A number of these people took advantage of their illusory expertise in health care policy to launch blogs which they used to promote their notions of ‘health reform’ and extol the virtues of government-run health care in general.

"Among them was an ER physician who writes under the nom de plume, 'Shadowfax.' (He wrote a blog post headlined "Medicare made the rules and now punishes doctors for following them")

“…it would appear that the virtues of government-run health care have begun to pall for the good doctor.
He has finally discovered what I and others told him years ago: Medicare rules are, as he apparently now realizes, 'arbitrary and disconnected from reality.' He has also noticed that, when a physician runs afoul of these bureaucratic vagaries, the government is the judge, jury, and executioner. The immediate cause of his disillusionment is Medicare’s trick of performing a superficial audit of a doctor’s billing practices and, based on a hopelessly flawed statistical sampling method, accuses him of fraud.

“You get a letter from the Medicare … telling you that you’ve been reviewed, found guilty of upcoding, and this finding, based on a handful of charts, is extrapolated back several years.” The term “upcoding” is industry jargon indicating that a provider has submitted a claim using codes that produce inappropriately high payment. It’s rarely done deliberately, assuming it has actually occurred, but that doesn’t matter. “The result is a large demand for reparations, usually in the mid-to-high six figures. The physician group can either write a check or lawyer up and argue it chart by chart.”

“Medicare uses a sampling method that makes a mockery of statistical analysis, its refund demands are often unjustified.

“…the attempt to save money by harassing physicians and exploiting the contradictions within the rules that the government itself wrote is beyond maddening.”

(End of Article)

For the life of me I cannot figure out why liberals think there is a federal government solution to every issue that "plagues" our nation.

The government is uniquely qualified to provide for the common defense of the nation through the military. It is uniquely UNqualified to do nearly every other task it attempts.

This morning, CBS reported on an outbreak of Legionare's Disease in a V.A. hospital (a government run "medical" bureaucracy), the result of mismanaged sterilization programs and lack of response when the disease surfaced. (This is the same V.A. responsible for my father's last two years of life being living torture, and the same V.A. that put my best friends broken leg on crooked so he had to have repeated surgeries to correct the issue.)

But think how much better life will be with the expanded bureaucracy required for AHA!

Let's hope for some more changes of minds and policies.

When will we learn that allowing the FEDERAL government to rule and regulate every problem we face will only result in more unintended consequences? Answer: As long as liberals are in control, Americans won't learn a thing.

David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.

Here's an article you might be interested in.

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