October 19, 2012


Auditing the Auditors  

Rich Umbdenstock, AHA President and CEO

Audits are supposed to serve an important purpose. Medicare and Medicaid payment rules are getting even more complex, and the volume of claims is significant. Errors are going to happen and need to be found and corrected. But audits need not be so costly and unproductive that they undermine their benefit.  We've heard you:  the Recovery Audit Contractor program has brought a flood of new and redundant audits, confusing standards of review, unmanageable medical record requests and too many inappropriate denials — 75% of denials challenged are overturned on further review.  We've taken that message to the Centers for Medicare & Medicaid Services repeatedly.  Now a bill has been introduced that would improve Medicare's auditing programs and ensure that auditors are monitored and penalized for too many mistakes.  Does this kind of clarity and sanity sound good?  Urge your representative to co-sponsor the Medicare Audit Improvement Act of 2012 (H.R. 6575).

Thanks,
Rich

 Questions or Comments?
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rich@aha.org

 

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