No settlement in sight in AHA v. Sebelius

It's not likely the American Hospital Association's lawsuit against the Centers for Medicare & Medicaid Services will end in settlement, AHA Assistant General Counsel Lawrence Hughes told Report on Medicare Compliance on AIS Health. The trade group and four hospitals in November filed suit (AHA v. Sebelius) over what they say are millions of dollars of denied Medicare payments based on setting. The hospitals allege that recovery auditors (better known as RACs) essentially second guess medical decisions, determining inpatient care should have been performed in an outpatient setting.

"We are willing to work with [HHS], as we expressed to them multiple times, but there is no indication a settlement will occur, at least not yet. The briefing schedule takes us through the middle of July," counsel said. Blog Post