The Effect of Hospital Charges on Outlier Payments under Medicare's Inpatient Prospective Payment System: Prudent Financial Management or Illegal Conduct?

Authors

R. Brent Rawlings, Hancock, Daniel, Johnson & Nagle, PC
Hugh E. Aaron, Healthcare Regulatory Advisors, Inc.

Abstract

An innovative examination of Medicare's outlier payment procedures, this article discusses the payment calculation in detail and offers an analysis of the legality of such calculations in the context of the allegations against Tenet Healthcare Corporation. The article examines the circumstances of the allegations and suggests that perhaps fiscal responsibility can be confused with illegal conduct on occasion.

First Page

267

Recommended Citation

R. B. Rawlings & Hugh E. Aaron The Effect of Hospital Charges on Outlier Payments under Medicare's Inpatient Prospective Payment System: Prudent Financial Management or Illegal Conduct?, 14 Annals Health L. 267 (2005).
Available at: https://lawecommons.luc.edu/annals/vol14/iss2/4