HME Audit Key data builds strong case

Thursday, July 7, 2016

WASHINGTON – Results are in for the AAHomecare HME Audit Key survey for the first quarter of 2016.

Sixty-nine percent of completed MAC prepayment audits nationwide were paid upon review, according to the survey, which included additional documentation requests from Oct. 1, 2015, through March 31, 2016.

Other results from the survey:

·      the average rate of audits denied increased 5% between the fourth quarter of 2015 and the first quarter of 2016, with the average percent of audits denied by net revenue ranging from 13% to 40%;

·      companies with net revenues from $3.6 million to $10 million had significantly higher denial rates—three times that of companies with net revenues from $0 to $1 million

While the survey is gaining momentum, industry stakeholders say increased participation is needed to gain support on Capitol Hill to create “smarter and fairer policies.”

“If future data on overturn rates confirms results like the ones we’re starting to see here, I believe we can make the case for reforms that both decrease the audit burden on suppliers and make better use of government resources,” said Kim Brummett, vice president of regulatory affairs for AAHomecare.  “What we need now is for more suppliers to join the program and complete the next survey round." 

Providers can begin submitting data for the second quarter of 2016 on July 15.