Hospital groups weigh in on changes to OIG guidance

Several state and national hospital associations last month weighed in on the Health and Human Services’ (HHS) Office of Inspector General’s (OIG) request for recommendations to revise the compliance program guidance for hospitals published by the OIG in early 1998.

The Federation of American Hospitals (FAH) in Washington, DC, told HHS Inspector General Janet Rehnquist that it agrees with the OIG that it would be appropriate to revise the guidance to include steps hospitals can take to ensure compliance with the complex Medicare outpatient payment system for hospitals.

"The OIG should recognize that it takes hospitals time to learn new payment systems, such as the outpatient prospective payment system, and that such learning curves’ should be considered when compliance is being evaluated," argues FAH vice president and chief counsel Michelle Fried.

The American Health Information Management Association (AHIMA) in Chicago maintains that compliance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates such as electronic transactions and code sets, privacy, and security, also should be incorporated into hospitals’ compliance programs and mentioned in the OIG guidance. Compliance with the HIPAA standards for electronic transactions and code sets is required by Oct. 16, 2002, but covered entities can request a one-year extension.

"The extension proviso is not well-understood by many providers and has caused confusion regarding the required compliance date," contends Dan Rode, vice president for policy and government relations at AHIMA. "This confusion may result in inadvertent noncompliance with the HIPAA regulations for electronic transactions and code sets."

In its comments, the Chicago-based American Hospital Association (AHA) points out that much of the current OIG guidance is oriented to the start-up of a compliance program.

AHA also argues the guidance should acknowledge the "variety of means" through which training can be accomplished, including approaches that do not require face-to-face participation. "This includes recognizing that requiring a minimum number of hours for each employee to be trained is often cumbersome, costly, and unnecessary," says AHA executive vice president Rick Pollack. "Guidance should leave to the discretion of the hospital the extent of training that is needed."