Consultant petitions for civil complaints court

'We are asking the government to step in and give us a voice'
Friday, March 28, 2014

No matter how much money you spend or how many lawyers you hire, you cannot sue Medicare. Consultant Roni Pidcock wants that to change. 

In February, she launched a petition on to designate a court of jurisdiction for civil complaints.

“What we are trying to ask is that they give providers the right to pursue their appeal,” said Pidcock, vice president of Quality Healthcare Systems. 

There are four levels of audits in the appeals process: re-determination, reconsideration, ALJ, and the Medicare Appeals Council. If you get to the fourth level of appeal and lose, no matter how wrong the audit contractor might have been, federal law says audit contractors have official immunity as government agencies, Pidcock says.

With the HME industry under siege from auditors, and a waiting period of more than two years to get assigned a hearing before an administrative law judge, the audit system is causing great harm to providers.

“We are asking the government to step in and give us a voice,” said Pidcock. “We need to be able to go after the people that are hurting us.”