North Carolina Lawmaker to Sponsor Audit Repair Bill

Rep. Ellmers steps up to spearhead legislation that would rein-in, repair CMS’s dysfunctional audit program.

Rep. Renee Ellmers (R-N.C.) will sponsor legislation to address CMS’s audit program, which has posed considerable difficulty for providers since the agency has intensified its program integrity efforts over the past few years.

CMS’s ramped up audit program has resulted in a deluge of recouped payments and documentation requests that not only created financial and operation difficulties for providers and their referral partners, but made it increasingly difficult for them to adequately serve patients.

Despite the difficult situation, providers across the industry have implemented tough new documentation policies and pushed their audit appeals to the highest available levels, often to good effect. Some providers were seeing at least a 60 percent overturn rate on audit appeals. This made the latest news about CMS’s recent decision to delay assigning administrative law judges to audit appeals for two years particularly frustrating.  

Not surpsingly, both the American Association for Homecare and the North Carolina Association for Medical Equipment Services applauded the welcome news about Ellmer’s effort.

“Congresswoman Ellmers has recognized an intensifying problem in the homecare industry,” said Robert Steedley, chairman of the AAHomecare Board of Directors and president of Barnes Healthcare Services. “We look forward to working with her to move this legislation forward.”

 “We appreciate and thank Congresswoman Ellmers for her understanding of the problems with the onerous audit system, as well as her continued efforts to address problems with competitive bidding,” said Tom Ryan, president and CEO of AAHomecare.

“As a result of her healthcare background, Rep. Ellmers knows how important it is to put the patient first,” said Beth Bowen, executive director of NCAMES. “This legislation will strengthen access to homecare for patients and protect the small businesses that serve them.”

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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