In wake of Sandy, CMS grants audit relief

Friday, November 9, 2012

BALTIMORE – HME providers who are dealing with the fallout from Hurricane Sandy won't also have to deal with audits, AAHomecare announced Nov. 7.

"We're very pleased with the decision CMS has made here," said Walt Gorski, vice president of government affairs for AAHomecare.

Providers located in parts of New York, New Jersey and Connecticut now have a 30-day reprieve from additional documentation requests (ADRs) from CMS contractors, according to the announcement.

This is a victory for AAHomecare and other industry stakeholders who have worked since the hurricane struck Oct. 30 to stop audits in affected areas.

"We certainly understand that there's no extra reimbursement for all the extra gasoline that we have trucked in from other parts of the country, overtime, extra equipment, etc.," said Lisa Getson, executive vice president, government relations and corporate compliance, for Apria, during a conference call to discuss Sandy relief on Nov. 7. "This is something that you should look at, that you can grant a reprieve for."

While CMS has granted some audit relief, providers aren’t out of the woods yet.

"What's important to recognize here is that the directive from CMS was effective Nov. 7," said Gorski. "However, there probably were medical review additional documentation requests that were in the pipeline that providers will still be receiving over the next several days. There's really nothing that could be done about that."

Another issue: CMS's leniency applies to providers in areas of New York, New Jersey and Connecticut, but those aren't the only providers affected by Sandy.

"You might have a provider who has beneficiaries in a certain area but who is located in Florida, for example," said Gorski.

As more information on these issues is available, CMS will post it to its emergency website