Audit Task Force: Be ready for ‘anything they throw at us’

Friday, September 20, 2013

WASHINGTON – AAHomecare’s newly resurrected Audit Task Force has developed a multi-pronged approach to fighting audits.

“Our industry is not seeing any audit relief,” said Jeff Mastej, director of compliance, audits and reimbursement for Wright & Filippis, and a member of the task force. “The goal is to work toward Medicare audit contractor reform relating to audits and coverage policies.”

The task force represents “a broad cross-section of association members,” AAHomecare says.

One of the task force’s first priorities: legislative relief. The Medicare Audit Improvement Act seeks to improve the Recovery Audit Contractor (RAC) program for hospitals. Stakeholders seek to broaden those efforts to include HME or, if that’s not possible, draft similar legislation.

“We certainly want it to be in a coordinated effort with them,” said Kim Brummett, senior director of regulatory affairs for AAHomecare.

The task force is also developing a tool—modeled after one used by the American Hospital Association—that would help providers track how many audits they are getting, as well as the types of audits. Pooled together, this data would help to provide the big picture, Brummett said.

“Many hospitals participate in a quarterly survey that speaks to the behavior of RAC auditors, but we are broadening that,” she said. “We want to do the same for CERTs, pre- and post-pay reviews, ZPICs, UPICs and anything else they throw at us.”

The task force would also like to work with the Medicare Administrative Contractors (MACs) to reduce denial rates. To that end, it is creating a series of checklists that providers can use to ensure they have the documentation they need to submit claims, Brummett said.

“We talked to a lot of seasoned providers for input to make these as succinct as possible,” she said. “We want them to be a useful tool.”