This Week's News
Congress seeks to simplify Medicare audits, relieve physician burden
AMA recommendations have led congressional leaders to request a closer look at federal fraud and abuse programs and their impact on physicians.
In a bipartisan letter sent June 26, three congressional committees called on the Government Accountability Office to produce a study that evaluates the numerous Medicare audit programs and ensures that the Centers for Medicare & Medicaid Services (CMS) is strategically coordinating these efforts.
The request comes on the heels of AMA testimony submitted in June to the U.S. Senate Finance Committee, the U.S. House Committee on Oversight and Government Reform, and the U.S. House Energy and Commerce Committee. The AMA underscored the need to transform CMS's numerous fraud and abuse audit programs into a streamlined, coordinated process that targets true fraud, eliminates duplicative efforts and minimizes the burden placed on physicians.
"To alleviate physician confusion and best utilize federal funding," the AMA states in a white paper submitted to the U.S. Senate Finance Committee, CMS should reduce "duplicative program integrity audits for physicians and … [adopt] streamlined audit policies and procedures."
The white paper outlines the AMA's strategy for program improvements and includes recommendations to increase oversight of audit contractors, streamline federal and state audit programs, penalize Recovery Audit Contractors for inaccuracy, and focus less on overpayment recovery and more on education to prevent improper payments before they occur.
The Government Accountability Office's report should complement CMS's own audit of its various auditing efforts, which the agency committed to perform last year in response to AMA advocacy.
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