The American Hospital Association (AHA) and four hospital systems in Missouri, Michigan and Pennsylvania filed suit against HHS last week over what the plaintiffs are calling a refusal on the part of the government to reimburse hospitals for "reasonable and necessary care" when recovery audit contractors (RACs) determine that the same care could have been provided at an outpatient facility, for less cost. "RACs, which are paid primarily on the basis of how much Medicare funding is taken back from hospitals and physicians, review these care decisions years later without ever seeing or talking to the patient." AHA asserts that "when hospitals appeal these questionable decisions, they prevail at least 75 percent of the time." AHA is asking the U.S. District Court in the District of Columbia to overturn the policy.