RAC bill getting hospital lobby's biggest push

Legislation to muzzle Medicare auditors has received the biggest hospital lobbying push this year—so far, to little effect.

The Medicare Audit Improvement Act of 2013 was the subject of more hospital lobbying reports so far this year than any other legislation, according to reports compiled by the Center for Responsive Politics. The lobbying push was led by the powerhouse American Hospital Association, which spent $4.3 million so far this year lobbying Congress. But the AHA's legislative push on the audit bill was joined by the Federation of American Hospitals and six state hospital associations.

The legislation, introduced March 19 by Rep. Sam Graves (R-Mo.), would modify the Recovery Audit Contractor program to establish a hard cap on additional document requests that Medicare auditors demand from providers, among other changes. The bill would limit the document requests to 2% of hospital claims and a maximum of 500 ADRs over 45 days.

The legislation was needed because hospitals—especially smaller facilities—were frustrated by the increasingly large administrative burdens stemming from Medicare audit contractors' document requests, Graves noted in a release.

“My bill would put in place common-sense reforms allowing auditors to still conduct adequate oversight of billing problems without an open-ended invitation from CMS to continually bombard hospitals,” Graves said. “Our smaller, rural hospitals are especially ill-equipped to deal with this increased administrative burden.”

Despite the hospital lobbying push, the legislation has yet to move out of either the Ways and Means or Energy and Commerce committees.

The legislation is actually a reintroduced version of a bill Graves authored in the last Congress, which also failed to move out of committee.

The Missouri Hospital Association stated in its lobbying disclosure documents that it was focused this year on increasing the number of co-sponsors for the bill. On that effort, at least there appears to have been some progress. The current legislation has 69 co-sponsors, while last year's bill gained the support of only 26 other members of Congress.

The California Hospital Association, which also has lobbied on the bill, recently hailed its growing number of co-sponsors in a post on the association's website.

Other healthcare groups also focusing lobbying efforts on the bill include the American Medical Association, the American Health Information Management Association and the American Association for Homecare.

Those lobbying efforts will likely expand with this week's introduction of a Senate version of the bill by two rural state senators, Mark Pryor (D-Ark.) and Roy Blunt (R-Mo.).

Rick Pollack, AHA executive vice president, said in a statement this week that his group's hospital survey has found those that dispute RAC denials through the Medicare appeals process successfully overturn RAC denials 72% of the time.

“This legislation provides much-needed guidance for auditors while keeping them out of making medical decisions that should be between patients and their physicians,” Pollack said.

Other legislation that has been the focus of hospital lobbying efforts this year, according to the disclosure reports, include the Children's Hospital GME Support Reauthorization Act of 2013 and the Protecting Seniors' Access to Medicare Act of 2013. The first bill passed the House on Feb 4, but the second bill has seen no movement since it was introduced Feb. 14.

Follow Rich Daly on Twitter: @MHrdaly