Association addresses error rates with physicians

WASHINGTON, D.C., Feb, 14, 2013—AAHomecare recently met with the American Academy of Sleep Medicine (AASM) in Chicago to discuss ways to work together to better educate sleep physicians to comply with Medicare’s complex documentation requirements justifying medical necessity for Positive Airway Pressure (PAP) devices. The academy agreed to work with AAHomecare to improve physician documentation compliance and invited the association to develop documentation education programs at AASM’s annual conference. Attending the meeting on behalf of AAHomecare were Walter Gorski, vice president of government affairs, and Kelly Riley, CRT, RCP, director of clinical networks at The MED Group.

This meeting is part of AAHomecare’s strategic plan to work with the physician community to improve documentation compliance with a goal of lowering the so-called “improper” payment rate for various types of durable medical equipment. According to the latest statistics from recent DME MAC probe audits, the “improper” payment rate for PAP is approximately 55-60 percent. The association hopes these efforts will also create opportunities to partner with physician groups to review Medicare DME coverage policies in order to make these policies more clear and less open to subjective review.

In return, AASM asked that AAHomecare work to educate its members on requirements that prohibit home care providers from unilaterally switching the type of equipment ordered by sleep physicians. Medicare rules do, however, permit a home care provider to provide different equipment than was initially ordered if it is done in consultation with the physician. For more information on AAHomecare’s efforts on reducing the burden of Medicare audits contact Gorski at [email protected]. Also go to www.aahomecare.org.