Lawmakers voice concerns on audits

Friday, May 23, 2014

WASHINGTON – Industry stakeholders say a Congressional hearing last week on audits is likely the first of many such hearings on the issue.

“This hearing is part of taking a look at the recovery audit contractor (RAC) audits which the hospitals are fully engaged in,” said Jay Witter, vice president of government affairs for AAHomecare. “Their issues are our issues and they are really boiling up now.”

Officials from the Center for Program Integrity, the Government Accountability Office and the Office of Inspector General testified at the May 20 hearing, held by the House Oversight and Government Reform Subcommittee on Energy Policy, Health Care and Entitlements.

It was clear from lawmakers’ comments during the hearing that they understand the negative impact of audits on HME providers.

“I have some serious concerns that the current system of post payment audits by RACs is resulting in a significant burden on some providers,” said Rep. Michelle Lujan Grisham, D-N.M., at a hearing held by the House Oversight and Government Reform Subcommittee on Energy Policy, Health Care and Entitlements, according to a bulletin from The VGM Group. 

With an audit reform bill expected to drop soon—possibly this week—the hearing, as well as the 250 Capitol Hill meetings conducted during the AAHomecare *Legislative Conference May 7–8, should have lawmakers primed to sign on as co-sponsors, say stakeholders.

“It’s a big issue on the Hill, given the administrative law judge situation,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “And it’s not just DME—the entire healthcare industry is up in arms. Billions of dollars are being held up.”

Relief can’t come soon enough for weary providers like Mike Calcaterra.

“All these auditors that are going through with all of these claims and then losing them on appeal and they don’t get money taken back,” said Calcaterra, northern zone vice president for Boise, Idaho-based Norco. “It just amazes me.”