AHA Takes Issue with Axios Piece on Medicare Claims Audits

A recent Axios newsletter article on hospital audits conducted by the Centers for Medicare & Medicaid Services’ Office of Inspector General “is misleading and only tells one side of the story by leaving out key information that readers deserve to know,” AHA General Counsel Melinda Hatton writes today in an AHA Stat blog post. “Most important, the article fails to mention that OIG’s hospital audits regularly include fundamental flaws and inaccuracies, both in OIG’s understanding and application of Medicare payment rules and in the procedures the OIG uses to conduct the audits. 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…America’s hospitals and health systems understand the need for robust and effective review of Medicare billing and payment practices and have presented CMS with five suggestions to improve the accuracy and fairness of the OIG audits.”