Health Information Management

Medicare Audit Improvement Act reintroduced

APCs Insider, March 29, 2013

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

On March 19, Congressmen Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) reintroduced the Medicare Audit Improvement Act,which aims to improve the performance of Medicare audit programs by implementing financial penalties for certain compliance failures.

The bill would amend the Medicare Modernization Act of 2003 to rectify problems identified since the creation of the Recovery Auditor program as a part of that law. Specifically, the Medicare Audit Improvement Act would reinstate and make statutory a hard cap on Additional Document Requests (ADR) on the part of Medicare auditors to 2% of hospital claims with a maximum of 500 ADRs per 45 days, according to a press release from Graves’ office.
The same day that the bill was reintroduced to Congress, the American Health Information Management Association (AHIMA) issued public support for the proposed legislation, saying that it will address critical operational problems that exist with the current Recovery Auditor program and that it will ensure that Medicare Recovery Auditing is efficient, transparent, and fair.
“Health Information Management (HIM) professionals are deeply involved in the collection of the health data that is the subject of the recovery audits, making them the point of contact for responding to the various and numerous audit requests,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA in the March 19 press release. “Although our members agree that it is important to review, audit and identify improper Medicare payments, the process has become overly burdensome and ineffective as evidenced by the high percentage of successful appeals.”
View the press release from the office of Congressman Graves.
View the press release from AHIMA.

View a previously released article from HCPro on the proposed legislation.

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular