More than a year after asking some hospitals about claims they coded as a discharge against medical advice (AMA), the HHS Office of Inspector General (OIG) has added the topic to its work plan.^[1] OIG cited a steady rise in the number of Medicare enrollees discharged AMA and possible links to higher death rates and medically underserved groups. OIG’s Office of Audit Services will develop a data brief on the rates and outcomes of AMA discharges and provide information to CMS and others “that can be used to address health disparities and improve enrollee outcomes.”

Hopefully, this is a step in the direction of getting rid of the term AMA, said Steven Grant, M.D., network chief physician advisor for the University of Vermont Health Network in Burlington. AMA discharges should be treated like any other discharges, with patients treated respectfully, offered prescriptions and follow-up care and reassured they can return, he said. “Whether someone leaves after listening to everything we say or leaves early, all those things should still happen.”