American Hospital Association (AHA) members and leaders were in Washington, D.C., this week for the AHA Annual Membership Meeting, and lobbied their members of Congress on many of the top issues outlined in the association’s 91-page-long 2014 Advocacy Agenda.

Among these are reforms to how recovery audit contractors (RACs) and Medicare administrative contractors (MACs) operate to fix a system that has become overly reliant on audits to fix mistakes. This has created a huge backlog in appeals and delayed payments as more than half of RAC payment denials are overturned on appeal, AHA tracking of the issue shows.

In addition, the AHA members asked policymakers to extend the regulatory timelines for 2014 meaningful use and to allow greater flexibility in meeting Stage 2 requirements for the use of electronic health records (EHRs).

Reimbursement cuts were also a top priority. The AHA wants legislators to pass a bill to create a two-year delay for Affordable Care Act (ACA) mandated cuts to Medicare and Medicaid Disproportionate Share Hospitals, change the two-midnight rule that is used to help determine when billing for an inpatient stay is appropriate, and create more flexibility in the 96-hour admission limits for Critical Access Hospitals.

Bills the AHA is seeking support for include the Disproportionate Share Hospital Reduction Relief Act (H.R. 1920), the Critical Access Hospital Relief Act (H.R. 3991/S. 2037), the Medicare Audit Improvement Act (H.R. 1250/S. 1012), and the Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188). The last bill would require CMS to adjust hospital readmission penalties for socioeconomic factors.

So far this week, the group has received encouragement from many legislators with powerful committee and other leadership positions in primarily the House, but also the Senate. According to the AHA, Rep. James Clyburn (D-SC), assistant Democratic leader for the House, thanked hospital leaders for their efforts to make the “delivery of health care more affordable and accessible for all Americans.” House Ways and Means Health Subcommittee Chairman Rep. Kevin Brady (R-Texas) committed to building bi-partisan solutions to post-acute payment reform and two-midnight policy. “We want you to accurately bill and be accurately reimbursed so you can focus on caring for patients,” he said, according to the AHA. Rep. Greg Walden (R-OR), chairman of the National Republican Congressional Committee, also told AHA members that he thought “the federal government needs to allow hospitals to do their job and stop overreaching, overregulating and overreacting.” Finally, Sen. Roy Blunt (R-Mo.) told the AHA members that he thought the RACs were “out of control” and that “RAC audits create lots of headaches, lots of costs, and more often than not for hospitals … the audit decision is reversed.”

The 2014 AHA Annual Membership Meeting was held from May 4 to 7.