Flaws exist in CMS’ auditing processes, a coalition of industry organizations indicated in a letter to the agency.
The organizations included LeadingAge, the American Academy of Hospice and Palliative Medicine (AAHPM), the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO) and the National Partnership for Healthcare and Hospice Innovation (NPHI).
The organizations pointed to “fundamental, long-standing” problems pertaining to the audit focus areas, overpayment recovery and adjudication processes, as well as auditor consistency and education.
“We urge CMS and its audit contractors to shift the focus of current audit and recovery practices from obtaining large initial ‘overpayment’ recoveries to halting billing practices and patterns that clearly reflect failure to comply with fundamental requirements of the program,” the organizations wrote in the letter. “In so doing, we expect CMS to reduce the disproportionate audit burden that has been placed on hospice organizations that have a history of providing high-quality care.”
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