Hearings held on audits, bidding

Wednesday, April 29, 2015

WASHINGTON – A pair of hearings this week shined another light on the HME industry’s issues with audits and competitive bidding.

On Tuesday, the Senate Finance Committee held a hearing on Medicare audits and the difficulty that providers face appealing denied claims.

“When any Medicare contractor decides that a claim should not be paid, it has a real effect on beneficiaries and providers, which is why it is so important that the appeals process allow these appeals to be heard in a timely and consistent fashion,” said Sen. Orrin Hatch, R-Utah, committee chairman, in his opening remarks.

A massive backlog at the Office of Medicare Hearings and Appeals means wait times of more than two years before a provider gets assigned an Administrative Law Judge hearing.

Among those who testified at yesterday’s hearing was Chief ALJ Nancy Griswold, who first called attention to the problem in a December 2013 memo.

On Monday, audits were also on the agenda at a hearing of the Small Business Administration. A handful of HME providers testified about the impact of not only audits but also competitive bidding on their businesses.