Probably
no move by the federal government in recent years has generated more
alarm than the so-called PATH audits in teaching hospitals. Late last
year, more than 40 named teaching hospitals, institutions, and
organizations filed suit to halt the audits, calling them retroactive
enforcement and a threat to the future of medical education. On April
27, 1998, a federal judge in California dismissed the case, saying it
was not "ripe" for litigation. Now the parties have to decide
whether they will appeal that decision.
"It is simply one of the greatest threats to the medical
education system that we have," said Ted Lewers, MD,
secretary-treasurer of the American Medical Association, one of the
organizations that has filed the suit. "It is a direct attack on the
medical schools of this country."
PATH stands for Physicians At Teaching Hospitals and
represents an attempt by the Office of Inspector General (OIG)
of the US Department of Health and Human Services (HHS) to determine if
teaching hospitals and other institutions comply with federal rules
about how teaching physicians should bill for care when a resident is
involved. In a June 21, 1996, letter announcing the plan to begin the
nationwide series of audits, the OIG wrote, "This initiative grows
out of the extensive work performed by the OIG at a major East Coast
university. The focus of the review was compliance with Intermediary
Letter 372 (IL-372), the Medicare rule affecting payment for physician
services provided by residents. We found that the institution was
© 1998 American Heart Association, Inc.
Cardiovascular News
Tracking a Tangled PATH