With hospitals across the country panicked over the government's anti-fraud tactics, American Hospital Association President Richard Davidson is planning to meet face-to-face with HHS Inspector General June Gibbs Brown for the first time.
Although other AHA executives have met with Gibbs Brown in the past, Davidson's move would be a first since Brown became inspector general nearly four years ago. It is expected to give weight to how seriously the association is treating the issue.
Davidson's decision comes after he and AHA top brass in Washington have been getting an earful from hospitals and the AHA board about what they view as unprecedented investigative tactics toward healthcare fraud and abuse, AHA executives said.
"(Gibbs Brown) issued an open letter to the industry earlier this year and has had an open door," HHS spokeswoman Judy Holtz said.
Several healthcare leaders already have taken Gibbs Brown up on her offer.
Thomas Scully, president of the Federation of American Health Systems, which represents the nation's investor-owned hospitals, and Jordan Cohen, M.D., president of the Association of American Medical Colleges, have met with Gibbs Brown on several occasions, Holtz said.
"Our contacts with June Gibbs Brown have always been through Fred Entin as our general counsel," said Richard Wade, the AHA's senior vice president for communications. "It's Dick Davidson's feeling that we would not surprise them. He's talked with her on the phone."
With Davidson meeting with Gibbs Brown, the AHA expects to "ignite the discussion," Wade said. The meeting is expected in October.
At its Sept. 12 meeting, the AHA board approved a resolution that urged all hospitals to implement Medicare and Medicaid billing compliance programs to avoid problems with federal fraud fighters.
"The members of the AHA are angry," said Reginald Ballantyne III, chairman of the association's board and president of PMH Health Resources in Phoenix.
He said the tone of the federal government is that everyone is guilty.
"Most people in the field have a clear impression that the way things used to be, it was a presumption by the government of an unintentional mistake or error," he said. "Now it appears to us that there is a presumption of guilt and something bordering criminal activity. The government ought not to be using spray paint."
While it was approved unanimously by the 25-member board, the resolution isn't binding on the AHA's 5,000 member hospitals.
In July the AHA called on the federal government to place a moratorium on new fraud investigations of hospitals under the federal False Claims Act. The AHA and others say the act gives the government the upper hand in billing probes (July 14, p. 12). Hospitals say its severe penalties prompt them to settle rather than fight it out in court to prove their innocence.