AHA launches offensive against OIG fraud audits
Asks for audit moratorium
Saying hospitals are "under siege" from the Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) fraud and abuse investigations, the American Hospital Association (AHA) has asked for a six-month moratorium on new audits.
AHA officials urged the HHS, the OIG, and Secretary and the Attorney General of the United States to adopt a six-month moratorium on the initiation of new, widespread actions under the False Claims Act, the federal legislation under which the investigations are being conducted.
More than 4,700 hospitals are presently, or will be involved, in responding to one or more federal government inquiries or investigations, according to the AHA.
"America’s health care providers are under siege by federal law enforcement and investigative personnel. Both hospitals and health care professionals are being forced to divert valuable resources from patient care. While we acknowledge that there are and have been clear instances of wrongdoing, fraudulent activity is the exception and not the rule in the latest wave of hospital inquiries. What were once considered billing errors that could be corrected in annual audits are now being treated as criminal activity," the AHA wrote in a letter to the federal agencies.
"We believe that both the health care field and the government can do better. Hospitals need to improve regulatory compliance as a core function, backed up with training and, where necessary, disciplinary action. Health care providers also need to tighten procedures for discovering both errors and genuine abuses. At the same time, the government must establish clearer guidelines and be willing to provide advice and support to institutions," the letter continues.
In keeping with the need for clearer guidelines, the AHA also announced it has will launch a new service to help hospitals establish formal compliance programs based on concepts within the draft guidelines for compliance from the OIG. (See related story, p. 177.)
As government regulations "become even more complex and confusing, more and more hospitals are looking for ways to ensure they meet all billing requirements properly, without sacrificing additional time and money that could be used for patient care," the AHA says.
The Health Care Compliance Service is being developed in collaboration with Coopers & Lybrand, LLP’s National Health Care Regulatory Practice. It will include a video, a workbook, an information hot line, a Web site, and optional consulting support from Coopers & Lybrand.
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