AAHomecare Looking for Audit Feedback

Association calls on providers to relate examples of where contractors are overstepping authorities.

Reacting to the increased number of claims audits plaguing HME providers, the American Association for Homecare is calling on providers to give examples of audit documentation requests exceeding requirements outlined by Medicare.

"If you have examples where CMS or its contractors have exceeded their authority in audits, please share the examples with us – specifically, CERT, RAC, DME MAC, ZPIC, or other audit letters that demonstrate that the audit is asking for documentation that is not required to justify a claim," a statement from AAHomecare reads. "It would be very helpful to get actual physician records to show that physicians simply do not document the way that the coverage decisions demand."

The association is asking providers to forward examples of such exceptional audit request to Walt Gorski at waltg@aahomecare.org.

Using the information, the association says it will be able to better craft an "audit accountability strategy" that will address audit activities with CMS and Congress. AAHomecare says it will reach out to the DME MAC medical directors and key personnel at CMS.

"We will coordinate our efforts with other stakeholder groups such as the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians," the association added.


About the Author

David Kopf is the Editor of HME Business.

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