AHA urges action to address flawed OIG hospital audits

In a letter this week, the AHA again urged the Centers for Medicare & Medicaid Services to take specific actions to address and prevent the serious problems that flow from hospital compliance reviews conducted by the Department of Health and Human Services' Office of Inspector General and its use of extrapolation. These audits "regularly include fundamental flaws and inaccuracies, both in the OIG's understanding and application of Medicare payment rules and in the procedures the OIG uses to conduct the audits," wrote AHA General Counsel Melinda Reid Hatton. "These flaws result in vastly overstated repayment demands, unwarranted reputational harm, and diversion of hospital and physician leaders' time from their core mission of caring for patients." The letter proposes five specific actions CMS could take that would have an immediate and positive effect for hospitals, patients and the Medicare program. “We hope CMS will carefully consider our proposal,” Hatton said. “The need to do so will increase exponentially as OIG has indicated it intends to apply extrapolation on all future audits.”