AHA-supported bill would make changes to RACs, other audit programs

AHA News Now

Reps. Sam Graves (R-MO) and Adam Schiff (D-CA) today introduced the Medicare Audit Improvement Act (H.R. 6575), legislation supported by the AHA to improve Medicare audit programs such as recovery audit contractors. The bill would establish a consolidated limit for medical record requests, and improve auditor performance by implementing financial penalties and requiring medical necessity audits to focus on widespread payment errors. Among other provisions, the legislation would improve recovery auditor transparency; restore due process rights under the AB Rebilling Demonstration; allow denied inpatient claims to be billed as outpatient claims when appropriate; and require physician review for Medicare denials. "No one questions the need for auditors to identify billing errors; but the flood of new auditing programs, along with confusing and conflicting regulations, is drowning hospitals with a deluge of redundant audits, unmanageable medical records requests and inappropriate payment denials," AHA Executive Vice President Rick Pollack wrote Graves and Schiff in letters of support for the legislation.

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