If Medicare Refuses to Pay, Is Medical Malpractice Involved?
Question by pumpernickel: If Medicare refuses to pay, is medical malpractice involved?
“This service cannot be paid when provided in this location/facility”. This is written on the Medicare summary.
Why would a government agency refuse to pay for a treatment in an ER? Is it possible that it is illegal to do certain procedures or to give certain drugs/medications in an ER?
Medicare covered part of the claim but not the part for the drug.
Best answer:
Answer by Barry auh2o
The facility simply did not sign an contact with Medicare. There’s nothing illegal about that, nor is there any indication of malpractice.
Answer by dustoff
It could be that Medicare does not consider the specific service provided appropriate to a hospital E.R. (i.e., nonemergency services that should have been provided at a clinic or doctor’s office) and therefore declines to pay the E.R. higher rates.
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