AAHomecare asks CMS to review prepayment process

Thursday, April 30, 2015

WASHINGTON – AAHomecare submitted comments to CMS this week in response to the agency’s request to the Office of Management and Budgetfor information about how its contractors perform prepayment reviewof claims. While AAHomecare acknowledged CMS’s duty to identify fraud, the association took issue with the way CMS has exercised that right and offered recommendations on how to reduce unnecessary burdens on providers. AAHomecare’s recommendations include requiring contractors to: develop, officially publish, and adhere to consistent documentation standards that apply prospectively in the four DME MAC jurisdictions;request only the level and quality of information necessary to perform a review;implement procedures to prevent repeat audits of a beneficiary’s claims for the same piece of equipment; and allow contractors to rely on documentation available in a provider’s records to verify physicians’ signatures or proof of delivery. The association also submitted comments regarding CMS’s request to the OMB for information on the onsite survey tool used by the National Supplier Clearinghouse for onsite inspections. AAHomecare called for CMS to allocate more resources to improve inspector training.