AMA Helps Doctors Overbill Medicare by Exaggerating Time Needed for Procedures

Thanks to the American Medical Association (AMA), some physicians in the United States can work 26 hours in a 24-hour day.

Actually, these doctors don’t work anywhere near these many hours in a day. But their billing to Medicare reflects exaggerated totals for medical procedures, like colonoscopies, that fall within AMA guidelines, according to The Washington Post.

This practice represents “one of the fundamental flaws in the pricing of U.S. health care,” wrote Peter Whoriskey and Dan Keating.

This overbilling starts with a 31-member AMA committee—the Relative Value Scale Update Committee (RUC)—that meets privately each year to establish values for most services performed by doctors. The values are then used determine what Medicare and most private insurers pay doctors for their work.

But the newspaper found that many of AMA’s estimates of the time involved in procedures are exaggerated—sometimes by as much as 100%.


http://www.allgov.com/news/where-is-the-money-going/ama-helps-doctors-overbill-medicare-by-exaggerating-time-needed-for-procedures-130723?news=850640