AMA, CMA support hospital's fight against Medicare audit

NEWS IN BRIEF — Posted Feb. 14, 2011

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The American Medical Association has filed a joint friend-of-the-court brief with the California Medical Assn. in support of a hospital's challenge to a Medicare audit.

The argument comes in response to a dispute between Escondido, Calif.-based Palomar Medical Center and the Dept. of Health and Human Services over an HHS attempt to reopen one of the medical center's Medicare claims 20 months after the initial payment. The medical center went through several rounds of administrative appeals to argue that the audit was unnecessary, but HHS said reopening a claim was not subject to appeal.

Southern District of California Court Judge Roger Benitez ruled in favor of HHS in July 2010. The case is on appeal in the U.S. Court of Appeals for the 9th Circuit.

The AMA called the HHS policy "arbitrary and capricious," and said the rules infringe on the right for judicial review. The medical associations are asking that the lower court decision be reversed and remanded.

Note: This item originally appeared at

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