Regulatory Council works to address audit crisis

WASHINGTON, D.C., Dec. 5, 2012—As waves of audits continue to slam the home care sector, the AAHomecare Regulatory Council recently wrapped up a two-day work session at its headquarters in Washington. The top focus has been audit issues including lowering error rates, auditor oversight, and face-to-face exam educational materials.

Unless the error rate decreases, the home care sector will continue to be the target of congressional pressure and fraud charges. Dramatic measures are needed to bring the rate down. The HME community must also highlight the auditor error rate, which is the rate at which their claims denials are overturned at the various appeal levels.

The Regulatory Council is also discussing educational materials for physicians to address deficiencies in the documentation procedures. Educating physicians about Medicare documentation requirements is a key priority because failures in this area are often cited as a reason for claims denials. The council decided on a number of strategies to address audit abuse and methods to establish accountability for auditors. Learn more here.