In a letter to Centers for Medicare & Medicaid Services Administrator Don Berwick, MD, the American Hospital Association urged CMS to require consistent designations of healthcare-acquired conditions across states and to relax deadlines in the proposed regulation for Medicaid HACs. The association's recommendations include the following: CMS and states should use the Medicare HACs list as the sole source from which the Medicaid HACs may be selected. Lists of HACs that vary from state to state would make it extremely difficult to manage interstate health systems, so AHA "strongly recommends" that CMS and states focus on a core set of conditions for consistency.