Task Force to Address ‘Audits at Every Turn’

ARLINGTON, Va. — The American Association for Homecare said last week it is forming a task force to address the increasing number of audits facing HME providers.

The new task force will look at the problems with HME claims that have been identified by a string of auditors, including ZPIC, CERT, OIG, RAC and DME MACs. The goal of the project, the association said, is to ease the growing impact of numerous audits and get “clear and defined rules that HME providers can follow in order to submit claims that can withstand the audit process.”

“Audits are strangling many, many good home care providers,” said Walt Gorski, AAHomecare vice president of government affairs. “When more than half the HME sector is cited for failing to comply with the rules, we believe the rules are broken and need to be fixed. Seen from a different perspective, the government is overturning physicians’ judgment more than half the time.”

The task force will be charged with developing a strategy that encompasses legislative solutions, regulatory remedies, education, outreach to increase stakeholder awareness and public relations to highlight the burdens that an “audit at every turn” creates.

Outreach efforts will include working with physician and other clinical organizations to educate providers who order or refer HME items and services about appropriate documentation to meet the medical necessity requirements in CMS coverage policies, the association said.