The audit crisis is continuing to gain attention on Capitol Hill as providers are desperate for relief. Many industry organizations, including the American Association for Homecare and VGM Associates, are very involved in the fight and participated in the Office of Medicare Hearings & Appeals (OMHA) meeting last week in Washington DC to hear concerns presented by health care providers.
AAHomecare recently sent a letter of protest to Department of Health & Human Services Secretary Kathleen Sebelius regarding the OMHA's decision to suspend assigning appeals to administrative law judges that come from RAC audits. The suspension will last two years in order to clear up a massive 357,000 claim backlog. AAHomecare noted in the letter that an unintended consequence of OMHA’s decision may be to shift more of the administrative burden and risk inherent in Medicare coverage and payment rules to beneficiaries as providers will be more reluctant to take on added risk of nonpayment.
Increased volumes of pre-payment reviews have caused this crisis, and CMS is directly responsible for both its own audit actions and those of its contractors that have brought the situation to this breaking point. Audits have been an intense topic of discussion the past two years at Region B Council meetings with the Jurisdiction B DME MAC as well as a focus of OAMES Medicare Workgroup and the AAHomecare's Regulatory Council
If you plan to attend the OAMES Medicaid Training. Seminar on March 13 at Quest Business Center in Columbus, there will be special session provided by a member of the AAHomecare Regulatory Council with the latest on Medicare audits and industry efforts to bring relief.
Also, AAHomecare has set up a dedicated email address (AuditProblems@aahomecare.org, please copy Kam Yuricich at email@example.com) to allow providers to quickly and easily share their audit stories. This information will play a critical role in getting relief. AAHomecare and OAMES will use these stories to help regulators and legislators understand the crushing impacts that audits are having, so please tell us what's happening with your business!