AHA responds to Finance Committee's open letter

AHA News Now

The AHA today sent the Senate Finance Committee recommendations to better prevent and combat waste, fraud and abuse in the Medicare and Medicaid programs in response to the committee's May 2 open letter to the health care community requesting suggestions. "[M]istakes are not fraud," the letter by AHA Executive Vice President Rick Pollack advises, "and the powerful weapon of the False Claims Act should not be wielded in a misguided attempt to correct or prevent mistakes….A powerful weapon like the FCA must be wielded appropriately and with significant care." AHA recommends "eliminating the overlap and duplication that exists in current program integrity oversight; limiting the unfettered discretion over treatment decisions now exercised by many governmental auditors and Department of Justice attorneys by establishing clear payment policies that underscore the central role of the treating physician in hospital admissions; and improving current proposals to facilitate hospitals' return of overpayments that result from mistakes." AHA also urged the Finance Committee to be alert to how fraud and abuse laws "are interfering with or inhibiting accomplishment of another of the Committee's goals - reforming the delivery system to advance quality, safety and efficiency."

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