Providers Plagued by CMS Backlog, Association Says

ARLINGTON, Va. — The American Association for Homecare issued a national press release May 19 “to underscore the Government Accountability Office finding that the processing of Medicare reimbursement claims for HME continues to be a problem — despite CMS efforts to implement reforms.”

Titled “Medicare Contracting Reform,” the March GAO report was conducted to gauge how CMS is implementing a reform of its claims-processing contractors, which Congress ordered in 2003. “The report exposed unrealistic expectations on the part of CMS, flaws in the reform process, and an inability of CMS to even confirm whether it can achieve the major goal set out for the reforms — a net savings to the Medicare program,” the association said.

AAHomecare’s statement went on to say:

Durable medical equipment providers, such as those supplying power wheelchairs and oxygen therapy, have been victims of the Medicare system’s questionable management. They are burdened by excessive audits, claim denials that are routinely overturned after time-consuming appeals, and documentation guidelines that often contradict previous policies. While the Centers for Medicare and Medicaid Services (CMS) cite cracking down on fraud as a rationale for some of these procedures, the way they have been implemented have harmed legitimate equipment providers.

“The home care community applauds efforts to root out Medicare fraud,” said Tyler Wilson, AAHomecare president. “But Medicare beneficiaries and those who provide them with vital medical equipment deserve a more efficient administrative process, one that does not create major obstacles for legitimate businesses that are serving some of the most vulnerable people in our society. This is wrong, and Congress and the administration should put an end to it.”

To read the GAO report, see www.gao.gov/new.items/d1071.pdf.

To read the full statement from AAHomecare, see blog.aahomecare.org.