The D.C. Circuit has released a fascinating opinion about the total meltdown of Medicare’s system of internal appeals. The case brings to mind the old paradox of the irresistible force and the immovable object: it’s genuinely vexing and about as difficult to solve.
As I explained eighteen months ago, Medicare’s got a big problem on its hands. A well-intentioned but poorly designed program that enlists private auditors to ferret out waste and fraud has backfired, generating hundreds of thousands of appeals—384,000 in 2013 alone—mainly from hospitals complaining (with some justice) that they’ve been unfairly penalized.
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