AHA blasts U.S. attorneys over False Claims Act

Perceived abuse of the False Claims Act, recovery audit contractors, anti-kickback laws and overly complex meaningful use rules are among the regulations that are extremely burdensome to the hospital industry, according to the American Hospital Association.

The AHA outlined these complaints in a letter to Rep. Darrell Issa, R-Calf., who is the new chair of the House Committee on Government Oversight and Reform. Issa had requested that the leaders of various industries detail which regulations are the most burdensome and costly to comply with and are restraining economic expansion and job growth.

"Hospitals are highly regulated at the federal level and, at times, those regulations place impediments in our members' paths as they continue to provide both jobs and healthcare to their communities," wrote AHA President Rich Umbdenstock.

Among the AHA's specific complaints: U.S. attorneys are abusing their authority to open up False Claims Act investigations "upon the discovery of evidence of a mistake or overutilization." RACs are "overzealous" in denying claims, leading to a significant administrative burden for hospitals.

The AHA also cited how the Stark laws, anti-trust laws and the Civil Money Penalty Law are interfering with hospitals' efforts to achieve true clinical integration. In the CMP case, the AHA wants a revision that would apply the law only if a physician receives incentives to withhold medically necessary care.

Issa's committee is expected to hold highly visible hearings on regulatory issues in the coming months.

For more:
- read the AHA News article
- read the AHA letter (.pdf)