In The Words Of An Ex-Bureaucrat

The following “Ironclad Rules” were authored by Larry Odey after leaving the then Health Care Financing Administration (HCFA) almost two decades ago before it became the Center for Medicare and Medicaid Services (CMS). Mr. Odey’s rules capture the organized chaos that CMS inflicts on hospitals and physicians when trying to bill Medicare for services rendered. Even commercial insurers have regressed to this foolishness to cut costs. The "rules" have increased provider administrative FTEs three or more times the number needed pre-price controls, even with the advancements in technology.

The Ironclad Rules of Medicare: by Larry Odey
Just because you have a code doesn't mean it's covered.
Just because it's covered doesn't mean you can bill for it.
Just because you can bill for it doesn't mean you'll get paid.
Just because you've been paid doesn't mean you can keep the money.
Just because you've been paid once doesn't mean you'll get paid again.
Just because you've been paid in one state doesn't mean you'll get paid in another state.
You'll never know all the rules.
Not knowing the rules can get you in jail.
There's always someone who doesn't get the message.
There's always someone who gets the message and ignores it.

When government is undisciplined and not accountable for the organized chaos it inflicts on healthcare providers through reimbursment policies, we should not be surprised that healthcare leadership reflects the same lack of discipline and accountability in preventing clinical errors and operational inefficiencies.