Stakeholders to lawmakers: Stop the audit madness

WASHINGTON - A small but determined group of HME stakeholders will travel to Capitol Hill this week to take on audits.

“We don't want to sit back and take it anymore,” said Lisa Willis, director of compliance for Jasper, Ala.-based Med-South. “We are at the point where you shut down the ALJs, and they've dragged their feet on all of the other audit (problems).”

The Office of Medicare Hearings and Appeals (OMHA) will host a daylong forum Feb. 12 to discuss an increased workload that has resulted in a backlog of some 460,000 appeals. In a Dec. 31 memo, the chief ALJ announced it would suspend assignment of hearings for appeals going back to July 15, 2013, for as long as two years.

This, despite a law that states providers that file an appeal must receive a decision within 90 days.

“Where in America do you have an appeal process where the government takes money and there's (no recourse)?” said John Gallagher, vice president of government relations for The VGM Group.

Gallagher will lead a group of about 15 providers to the Hill. They will attend Wednesday's forum and live tweet using the hash tag #VGMAuditMadness. On Thursday, they will meet with key members of Congress, including members of the Ways and Means, Energy and Commerce and Senate Finance committees. Among their asks: suspend audits immediately, and stop recoupments on current claims denials that are waiting for an ALJ hearing.

“I recognize that they are shorthanded but the guidelines clearly state that there's a time limit,” said Willis.

CMS, in an email to HME News, said that the agency “does not forsee halting audits.”