Senate Takes up Bill to Improve Medicare Audits and Address RAC Concerns

A new Senate bill addresses provider concerns over the Medicare audit process, including the role of Recovery Audit Contractors. The House is also considering a version of the “Medicare Audit Improvement Act of 2013,” which lawmakers originally introduced in October 2012 and reintroduced in March.

Sen. Roy Blunt (R-MO) introduced the bill on May 22. In a letter to him, the American Hospital Association applauded the measure and expressed some audit concerns that long-term care providers share.

The AHA letter referred to “a deluge of redundant audits, unmanageable medical record requests and inappropriate payment denials.” It also raised the issue of RACs being paid fees for identifying errors, which could motivate them to focus on maximizing their own payments rather than following best practices for audits.

The bill includes measures to rein in auditors and improve audit quality by imposing financial penalties and improving transparency.

As of May 28th the full text of the Bill has not been posted. Once it is available it can be accessed at http://thomas.loc.gov.

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