AHA urges OIG to stop extrapolating Medicare audit findings

The American Hospital Association has sent a letter to HHS' Office of the Inspector General urging the agency to stop conducting "hospital compliance reviews" and extrapolating the findings of audits.

The OIG uses hospital audit findings to estimate Medicare overpayments to hospitals. In its letter, the AHA said there are numerous legal problems with the extrapolation method, such as the amounts being artificially inflated since the overpayment amounts are not offset by the amount of Part B payments "to which the OIG acknowledges the hospital may be entitled for inpatient stays that the OIG concludes should have been outpatient encounters" the letter read.

According to the letter, another flaw in the process is there is no "clear process for hospitals to challenge the OIG's sampling and extrapolation methodology through the claim appeal process."

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