The American Hospital Association (AHA) and other groups objected to and began a campaign against the expansion of a pilot program to audit Medicare claims, citing concerns about contingency fees. (Kaiser Network)
Under the program, private-sector auditing firms will examine Medicare claims by hospitals and other providers, and the firms will receive contingency fees based on how much money their assessments save the government. Hospital groups believe that such fees encourage auditors to be too aggressive.
The new program recouped $247 million in overpayments in fiscal year 2007 after it was launched in California, Florida, and New York. The program will be expanded across the nation this year. AHA vice president Don May told the Wall Street Journal:
“Any kind of question is a reason for denial…Going at it from this kind of perspective really isn’t, I don’t believe, in the best interest of taxpayers.”