AHA: Stop "Flawed" and "Redundant" OIG Hospital Compliance Reviews

The American Hospital Association has called on HHS to bring a stop to the HHS Office of Inspector General's hospital compliance reviews.

In a letter to HHS Secretary Kathleen Sebelius, AHA Executive Vice President Rick Pollack wrote the reviews conducted by the OIG Office of Audit Services are "entirely redundant" to the reviews carried out by Medicare recovery audit contractors, which focus on the same types of claims (e.g., short inpatient stays).

Furthermore, Mr. Pollack wrote the OIG's audit findings and estimated overpayments are incorrect. He alleges they misconstrue and misapply numerous Medicare regulations and policies. For example, according to Mr. Pollack, many of the hospitals the OIG has audited are without fault under Section 1870 of the Social Security Act, which specifies a hospital is without fault, in the absence of evidence to the contrary, when the overpayment determination is made after the third year following the year in which a Part A payment was originally made.

"The Kafkaesque burden of imposing duplicative audits on hospitals and recouping payments from them without correcting the OIG's manifold and glaring errors is abusive and unfair to hospitals and a waste of government resources," Mr. Pollack wrote.

More Articles on Hospital Audits:
Illinois Paid $12M in Health Costs For Deceased
Medicare RAC Activity in Q1 2014: 10 Statistics
OIG: Medicare Inappropriately Paid Inpatient Claims Under Post-Acute Transfer Policy 


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