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News of the Day ... In Perspective

04/20/2006

Guilty…of charity

A massive study funded by the Robert Wood Johnson Foundation has discovered that only 68 percent of doctors say they give any free or discounted services to low-income patients, down from 78 percent 10 years ago.

Suggested causes included medical school debt, tight schedules, and inadequate fee schedules.

Donald Devine, a professor of political science at Bellevue University and former manager of the Federal Employees Health Benefit Program, the largest employer health insurance plan in the nation, learned the real reason—from one of his students.

The student is a Coding and Compliance Manager. She told the professor that Medicare and Medicaid consider it fraud if a physician charges any patient less than the amount that the government must pay for a given service. In he event of an audit, the government will scrutinize all the charts to be sure nobody got a better deal than the government.

If the physician forgives a debt from one indigent patient, then the government never has to pay for any such procedure. The doctor is allowed to make exceptions in case of need—if he properly documents it. “But who will take the time or the risk?” Devine asks.

“When one reads about doctors being hauled off to jail for fraud,” Devine continues, odds are that he is “guilty not of fraud but of charity.”

The number of charitable services would be less if doctors did not count free hospital care for indigents, which is compulsory and hence not really charitable. Most charitable services are offered by small practices, which don’t hire people like this student to warn them against it—yet. (Donald Devine, Washington Times 4/3/06)

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