Coding System Controversy Leads To Hospital Funding Reductions in Fiscal Cliff Deal

Behind The Fiscal Cliff Deal, A Prolonged Hospital Finance Fight by Jordan Rau.  Kaiser Health News.  January 3, 2013.

Reductions to hospitals in the fiscal cliff deal may total $15 billion over a decade.  As a result of a 2007 change in the way hospitals submit bills for Medicare patients, there has resulted a running controversy about whether hospitals were overcharging Medicare.  The 2007 coding system made it easier for hospitals to more specifically describe their level of service to patients.  The Centers for Medicare & Medicaid Services studied trends in billing and determined that there was indeed substantial overbilling.  The fiscal cliff legislation allows Medicare to recoup overpayments made between 2010 and 2012.  The proceeds of the recovery will be used to meet scheduled cuts to payments to doctors who treat Medicare patients.  In addition, the fiscal cliff deal extends until 2022 ACA reductions in payments for hospitals that treat large number of uninsured/poor patients.