AHA briefing highlights legislative priorities to protect patient access to care

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Hospitals cannot sustain further payment cuts without jeopardizing patients’ access to needed care, AHA representatives told reporters today during a telephone briefing on its legislative agenda. As Congress looks for savings and potential offsets for physician payment reform and other spending, AHA is urging lawmakers to protect hospital payments, provide relief from excessive and harmful policies, and support rural health care, said Tom Nickels, AHA senior vice president of federal relations. Hospitals have already absorbed $113 billion in new legislative and regulatory cuts to Medicare and Medicaid payment since 2010, and face mounting pressure from a huge array of policy changes, such as Medicare’s Recovery Audit Contractor program and two-midnight policy for inpatient admission and medical review criteria. Participating in the briefing, Steven Hanks, M.D., Hartford (CT) HealthCare’s vice president of medical affairs for the central region, said the five-hospital health system has had nearly $40 million in claims denied for medical necessity since December 2010, but that the vast majority have been overturned on appeal, a costly process that can take years. “It’s pretty clear RACs are just tossing a broad fishing net, because they’re not penalized,” Hanks said. Among other legislation, AHA supports the Medicare Audit Improvement Act (H.R. 1250/S. 1012) and Two Midnight Rule Delay Act (H.R. 3698).

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