American Hospital Association

News & Analysis as of

OIG Responds to Hospital Compliance Review Objections

The OIG has defended its hospital compliance review policies in response to objections raised by the American Hospital Association (AHA). Specifically, a January 15, 2015 OIG letter addresses four main areas of AHA concern...more

ProMedica and the AHA Seek Guidance from SCOTUS on Hospital Consolidations and Mergers

The New Year started out with a bang in the healthcare antitrust circles with ProMedica Health Systems Inc.’s (“ProMedica”) well-publicized petition to the US Supreme Court and the American Hospital Association’s (AHA) amicus...more

Medicare Hospital Compliance Reviews are Legal and Sound, According to OIG

The Office of Inspector General for the Department of Health and Human Services (OIG) recently defended its practices pertaining to hospital compliance reviews in a published response to a letter from the American Hospital...more

No Judicial Relief to the ALJ Waiting Game — Yet

In May 2014, the American Hospital Association filed suit against the United States Department of Health and Human Services seeking to compel Administrative Law Judges (ALJs) to comply with applicable statutory deadlines for...more

OIG Defends Its Hospital Compliance Reviews in Response to AHA Criticism

The Office of the Inspector General for the Department of Health and Human Services(“OIG”) responded to concerns expressed by the American Hospital Association (“AHA”) regarding the OIG’s hospital compliance reviews,...more

AHA Responds to House Bill Concerning RACs and Two-Midnight Rule

In a December 18, 2014 letter to U.S. Representative Kevin Brady, the American Hospital Association (AHA) voiced its opinion on a discussion draft of the Hospital Improvements for Payment Act of 2014 (HIP). The House Ways and...more

D.C. District Court Dismisses Lawsuit Challenging Backlog of Medicare Appeals

On December 18, 2014, the U.S. District Court for the District of Columbia dismissed a lawsuit filed by the American Hospital Association (AHA) and others to compel the Secretary of HHS to process Medicare reimbursement...more

AHA Proposes Putting RACs on the Rack

The American Hospital Association formally proposed last week that Recovery Audit Contractors (RACs) be fined when their denials are overturned on appeal....more

CMS Releases Proposed Revised Medicare Shared Savings Program Regulations

The Centers for Medicare and Medicaid Services released, on December 1, 2014, a proposed rule to revise the Medicare Shared Savings Program (“MSSP”) Accountable Care Organization (“ACO”) Regulations. The proposed rule is...more

District Court Rejects Hospitals' Challenge to CMS's Rebilling Policy

On September 17, the United States District Court for the District of Columbia ruled that it lacked jurisdiction over a challenge brought by the American Hospital Association (AHA) and several hospitals and systems (the...more

Court Dismisses AHA’s Challenge to CMS Billing Policy

On September 17, 2014, the U.S. District Court for the District of Columbia dismissed a lawsuit brought by the American Hospital Association (AHA), three individual hospitals, and two health care systems that challenged CMS’s...more

AHA Files Joint Amicus Brief in Supreme Court FCA Case

The American Hospital Association (AHA) recently filed a joint amicus curiae brief with several other associations, including the American Medical Association and the Pharmaceutical Research and Manufacturers of America,...more

HHS Asserts the Everybody-Does-It Defense

If that sounds familiar, your child may have a future as a lawyer for Health & Human Services. Because that’s one of the primary arguments asserted by HHS last Friday in its motion to dismiss the lawsuit by the American...more

AHA Responds to Proposed Home Health Face-to-Face Changes

As previously reported, on July 7, 2014, CMS issued the Calendar Year 2015 Home Health Prospective Payment System Proposed Rule (Proposed Rule). On August 18, 2014, the American Hospital Association (AHA) submitted comments...more

AHA Renews Complaints about OIG Hospital Compliance Reviews

The American Hospital Association (AHA) has renewed its complaints about OIG “hospital compliance reviews.” Last Thursday AHA Executive Vice President Rick Pollack sent a letter to Health & Human Services Secretary Burwell...more

Hospitals File Lawsuit Over Medicare ALJ Hearings Delays

Over 460,000 appeals requesting hearings before an administrative law judge (ALJ) were pending in the Office of Medicare Hearings and Appeals (OMHA) at the end of 2013, with 15,000 new appeals being submitted each week. At...more

Hospitals Urging SCOTUS to Limit False Claims Act Penalties

What do a moving company and a hospital association have in common? The False Claims Act (FCA). The American Hospital Association along with the United States Chamber of Commerce and the Pharmaceutical Research and...more

Is It a Violation to Help?

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius confirmed HHS’s position that private, not-for-profit...more

Health Care Reform Implementation Update - May 2014

Congress held several hearings last week ranging from Sylvia Burwell’s nomination for Secretary of the Department of Health and Human Services (HHS), to Medicare payment oversight, to post-acute care in Medicare. The Centers...more

OFCCP Setting Its Sites On TRICARE Providers?

Healthcare providers are waiting anxiously to see the Office of Federal Contract Compliance Programs’ (OFCCP) most recent position on whether it will continue trying to assert jurisdiction over them on the basis of...more

AHA Challenges to the Two-Midnight Rule - Preserve Your Hospital's Right to Challenge

The American Hospital Association (AHA), along with several state and regional hospital associations and several hospitals, recently filed two lawsuits challenging CMS’s two-midnight rule and related policies....more

American Hospital Association Releases New RACTrac Results

Hospital providers continue to report increases in RAC activity, according to the results of the American Hospital Association’s (AHA) most recent RACTrac survey, which reports survey results from the second quarter of 2013. ...more

AHA Survey Continues to Bird Dog RAC Program

The American Hospital Association (AHA) published its RACTRAC Survey results for the fourth quarter of 2012. ...more

Hospitals Provided Temporary Relief In Medicare Rebilling Policy

The Centers for Medicare & Medicaid Services (CMS) released a ruling and an interim rule that, effective immediately, will allow hospitals to rebill certain inpatient hospital services as outpatient services for one year...more

AHA Survey Identifies Continuing Problems with Medicare RAC Program

The American Hospital Association (AHA) published its RACTRAC Survey results for the third quarter of 2012. The AHA created the survey in response to the lack of information released by CMS on its Medicare RAC program. For...more

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