A house divided . . . cannot lobby Congress

The AHA pushes for changes to help members

Lobbyists for the hospital industry, including the American Hospital Association (AHA), recently proved how a united voice can change things in Washington. According to a story in The Wall Street Journal (April 9, p. A3), lobbyists complained about the Justice Department's heavy handed-approach to pursuing suspected Medicare fraud by hospitals. Lobbyists said the False Claims Act is being used to browbeat hospitals into paying stiff penalties over innocent billing mistakes and sought a moratorium in the investigations.

Although the government refused to suspend anti-fraud initiatives temporarily, the Justice Department did agree to take less aggressive tactics in its fraud and abuse campaign. The government agreed to stop sending letters telling hospitals they were suspected of violating the False Claims Act and urging them to settle fines quickly. The AHA says many of its members in recent months have been slapped with stern Justice Department demands for restitution of Medicare money, plus damages, that the government claims were owed because of the billing of false claims.

'The wrong way to enforce the law'

The False Claims Act allows the government to recover triple damages and a fine of $5,000 to $10,000 for each claim. Many hospital administrators have been advised by attorneys to pay the triple damages quickly to avoid fines.

The Journal reported that even supporters of the act agreed the letters sent by the Justice Department were too harsh. Sen. Charles Grassley (R-IA), who is a strong supporter of home care, said the demand letters "were meant to scare people and that's the wrong way to enforce the law."