Full plate: AAH tackles audits, bidding, consumer engagement

Friday, March 14, 2014

LAS VEGAS – AAHomecare is on the verge of making announcements in three key areas, association officials told Medtrade Spring attendees on March 11.

Audits: Time to force things to happen

After trying to work with the administration and CMS on reforming the audit program for several years, Jay Witter, vice president of government affairs, said, “There are things that need to be forced to happen” through legislation.

“(A bill) is close to being finalized,” he said. “We’ll make an announcement very shortly on this huge audit effort. We’re working with lawmakers and we’re working with other (healthcare) groups. We’ll need your help.”

While association officials didn’t detail the legislation, they said it pulls from a list of recommendations to the administration and CMS. Those recommendations include conducting independent reviews of contractors, implementing interest penalties when claims are overturned, limiting the number of audits a provider can receive during a given period, and reinstating “clinical inference.”

“Some of those are inside the legislative language, some are just goals in working with the MACs individually,” said Kim Brummett, senior director of regulatory affairs.

AAHomecare officials also said they’ve met with a developer to create an Internet-secure tool for tracking audit data similar to the American Hospital Association’s RACTrack. They estimate it will cost $250,000.

“(We) need to raise funding,” Brummett said.

Competitive bidding: We have leverage

CMS’s recent request for comments on how to take competitive bidding nationwide in 2016 has raised the stakes on the industry’s fight to derail the program, AAHomecare officials said.

“Who’s not in a bid area?” Tom Ryan, president and CEO, asked attendees. “Guess what—you’re now in the soup.”

That fight got a boost recently when members of the Senate Finance Committee included a competitive bidding-related provision on licensure in their draft doc fix bill.

“(It’s the) first time the committee has voiced concern with bidding,” Witter said. “That gives us leverage.”

Association officials are in continued talks with lawmakers to expand that provision to include more substantive relief, including elements of H.R. 1717, a bill to replace competitive bidding with a market-pricing program (MPP).

“We’re working to get something done in a very short time,” Witter said.

Consumer engagement: 'I need my HME'

AAHomecare officials said they have a renewed focus on engaging consumers on issues like audits and competitive bidding, after hearing, in meeting after meeting with lawmakers: “Why aren’t they complaining?”

“Because you’re doing such a good great job, the patient has never known what’s going on,” Witter said. “We’re at a point now where it just can’t be done anymore. Patients are getting frustrated, and that’s going to be the driving force. We need a campaign, ‘I need my HME; don’t take it away.’”