AAH moves past anecdotes in audit fight

Friday, June 27, 2014

WASHINGTON – It’s no secret that audits are out of control, but without data it’s hard to build a case. That’s the problem AAHomecare hopes to help the industry fix with its HME Audit Key.

“We’re trying to make a stand that it’s over the top, but we don’t have any numbers to back that up,” said Kim Brummett, vice president of regulatory affairs for the association. “If we don’t have any numbers that we can share, at the end of the day, it’s all anecdotal stuff.”

With HME Audit Key, providers will use a secure electronic form to answer questions about audits, including how many they have at the redetermination, reconsideration and ALJ levels, and how many appeals they’ve won. The anonymous submissions will be compiled into a data set that AAHomecare can examine to see the impact of audits and share with lawmakers. 

HME Audit Key is part of a multi-pronged effort that AAHomecare has undertaken since restarting its Audit Task Force last fall. The association has also been working closely with Rep. Renee Ellmers, R-N.C., on introducing a bill to reform the audit process.

AAHomecare’s goal is not to eliminate audits, but to reform them.

“We want smart audits,” Brummett said. “We want them to be thorough and good and make sense, and hold people accountable.”

While AAHomecare has been collecting anecdotes about audits via email, HME Audit Key is all about the numbers. And for valid statistics, it needs a large sample size.

“We need to get as many providers to participate as possible,” said Tom Ryan, president and CEO of AAHomecare. “Our goal is to get everyone to understand this is an industry-wide effort, not just an AAHomecare member effort.”

In June, AAHomecare kicked off a campaign to raise $250,00 over two years to develop HME Audit Key, and create and maintain a secure database to support it, Brummett said. 

Brummett said AAHomecare expects HME Audit Key to be ready for a trial run, if not ready for use, by the end of 2014.