Author Question: What is the rationale the AMA is using to oppose the do-not-pay list? 1. Physicians assert each ... (Read 12 times)

MirandaLo · **on:** Jul 7, 2018

What is the rationale the AMA is using to oppose the do-not-pay list?

1. Physicians assert each patient's circumstances are unique and complications cannot always be prevented or explained.
2. The physicians assert this reimbursement ruling is unjust.
3. The physicians assert the do-not-pay list is punitive to health care providers.
4. The physicians assert do-not-pay list minimizes complications.

Question 2

Which of the following statements is true about the do-not-pay list?

1. If a patient develops a complication, Medicare will reimburse for all services.
2. If a patient develops complications, Medicaid will reimburse for all services.
3. If a patient has certain complications during the hospital stay, Medicare will not reimburse the hospital at the higher rate for the treatment.
4. If a patient develops a preventable complication, Medicare will demand the immediate transfer of the patient to a different health care setting.

morganmarie791 · **Reply #1 on:** Jul 7, 2018

Answer to Question 1

1
Rationale: The AMA opposes the do-not-pay list, stating there are better methods of controlling health care spending and reimbursement costs. Physicians fear the do-not-pay expansion will have a reverse affect on the quality of care. Each patient's circumstances are unique and complications cannot always be prevented or explained (Medicare-medicaid.com, n.d.).

Answer to Question 2

3
Rationale: Under the do-not-pay rules, if patients develop certain medical problems during their hospital stay, Medicare will not reimburse the hospital at the higher rate for the treatment of the complication. However, it will still pay for treatment related to the primary diagnosis and other complications not on the list. The physicians who provide that care are not under the rule.