Hospital Association RAC Audit Bill Reintroduced


Last year the American Hospital Association (AHA) whose members are also under siege from RAC audits secured introduction of legislation that would be generally helpful to the plight of hospitals whose audit problems are Part A claims applying to hospitals only but are not unlike the RAC audit issues faced by O&P. But the AHA legislation basically only addresses Part A claims issues applying to hospitals.  It sadly provides no panacea or relief for O&P RAC audit problems. Similar legislation has been introduced in the 113th Congress – S. 1012 and a similar House version HR 1250.

The AHA, like AOPA, also filed a lawsuit late last year against CMS.  That lawsuit may have been instrumental in CMS making some helpful changes in the audit procedures for the hospitals but those changes did not solve the problem.  The Senate version and House version of the newly introduced legislation are similar to that introduced last year through the auspices of AHA. Click here to read AOPA’s analysis of the AHA legislation and what it will and will not do.

AOPA is pleased that other organizations whose members are suffering from RAC audit are taking strong actions and helping create further awareness on the part of the general public, the Congress and, ultimately we hope CMS.

As for an update on AOPA if you haven’t read AOPA’s complaint. You will also want to read the AOPA announcement to members when the lawsuit was filed and you will see information on how you can financially support the lawsuit effort.  The anticipated next step is that CMS during the next 30 to 90 days will likely file a motion to dismiss the AOPA lawsuit.  If our complaint survives that motion and the judge gives the lawsuit a green light, then your Board of Directors will seriously consider seeking a Temporary Restraining Order forcing CMS to revert back to pre-“Dear Physician Letter” audit practices until the case is resolved