AHA responds to New York Times editorial
AHA News Now
Oct 4, 2012
In a letter today to the New York Times, AHA President and CEO Rich Umbdenstock said America's hospitals strongly agree with the newspaper's call for the government to establish national guidelines on how to bill properly for services, and has repeatedly made the same request. "It's critically important to recognize that more accurate electronic documentation and coding do not necessarily equate with fraud," the letter adds, noting that government payment rules are highly complex. "No one questions the need to identify billing mistakes; but the flood of new auditors is deluging hospitals with redundant audits, unmanageable medical record requests and inappropriate payment denials. A recent American Hospital Association survey found that denials were appealed at a 75% success rate. What's needed is clearer guidance, not additional audits that divert resources from patient care." The newspaper recently alleged that electronic health records may be used by some hospitals and physicians to increase their Medicare reimbursements through "upcoding" and the "cloning" of records. The AHA has proposed a framework for national guidelines for reporting hospital emergency department or clinic visits on 11 occasions since 2001.