Your Post-PHE Audit Strategy

The New Year has arrived, and CMS’s audit game plan has started to come into focus. So far is that CMS has indicated that it intends to audit claims filed during the COVID-19 pandemic, but have so far has shied away from doing so and instead has been auditing mostly non-pandemic related claims such as wheelchairs, hospital beds and urological supplies. That is changing this year, and understanding what could happen will be important for suppliers who have filed claims with CR modifiers during the PHE.

But the PHE is just one factor that will impact audits for HME providers in the coming months: the ALJ backlog is nearly caught up, and the chances are high that once it is, CMS might loosen some of the restrictions it has had in place with the Recovery Audit Contractors causing an increase in audit activity. Also, a new SMRC contract with CMS’s Program Integrity Group hit the ground running in 2021 with enormous audits on thousands of claim lines at one time. This presentation will provide an update on what we have seen thus far and a detailed assessment of what we see happening with audits this year.

Learning Objectives:

  • Identify potential audit strategies that CMS might implement post-pandemic
  • Learn what to anticipate with RAC, TPE, and SMRC audits in 2022
  • Identify strategies a supplier can implement to mitigate audit risk 

Date: Wednesday, February 9, 2022
Time: 2:00 p.m. (Eastern) / 1:00 p.m. (Central) / 11:00 a.m. (Pacific)
Duration: 1 hour

Wayne van HalemWayne van Halem founded The van Halem Group in 2006. The Atlanta-based firm merged with VGM Group in 2014 and Wayne currently serves as its President. The van Halem Group assists providers navigate complex issues related to audits, appeals, enrollment, coding, education and compliance. Wayne is also a published author and well-known lecturer. He also sits on the Advisory Board for HME Business Magazine, American Association for Homecare’s Regulatory Council, Medtrade’s Educational Advisory Board, Medicare DME MAC Jurisdiction D Advisory Council, and Board of Directors for Friends of Disabled Adults and Children (FODAC) and the Georgia Association of Medical Equipment Suppliers (GAMES). Since 2006, his company has saved clients over $100 million in overpayments and denial recoveries.

A certificate of attendance is available for all individuals who register and attend the full webinar (live or on-demand).

All registrants will have access to the live event and an on-demand recording of the presentation. If registrants want to watch the presentation again or have a scheduling conflict, they can register and access the on-demand version of this webinar, which will be available after the live event.

A special thanks to our sponsors for providing this free event.

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