ARLINGTON, Va. — According to a late Friday message from the American Association for Homecare, RAC audits in Jurisdiction D are targeting CPAP equipment and supplies for recoupment when the Medicare program did not pay for the sleep test.
"The association is very concerned that because CPAP therapy is frequently prescribed prior to an individual becoming Medicare eligible, many providers who furnish replacement equipment and supplies will be targeted for recoupment," the message said.
Based on advice from its CPAP workgroup, the association had these recommendations and reminders for HME providers targeted for such a RAC audit:
- 1) Make sure it is a RAC audit.
- 2) Remittance advice remark code N432 is used to identify RAC adjustments. This code appears on the claim level header detail line of your Medicare remittance advice.
- 3) Offset of the overpayment will occur on day 41 from the date of the demand letter if payment has not been made or there a request for an appeal.
- 4) File a Medicare DME redetermination request form.
AAHomecare said it is bringing up the issue with DME MAC officials in Jurisdiction D (Noridian Administrative Services) as well as CMS staff who oversee RAC activities "in an effort to correct the interpretation now being applied by the RAC contractor."
Health Data Insights is the RAC contractor in Jurisdiction D.
