VNAA Meets with GAO on Audit Issues
Monday, February 18, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy




On February 5, VNAA met with the Government Accountability Office (GAO) to discuss post-payment audit reviews. Involved in the conversation were five VNAA members with expertise to share on auditing and how contractors work with providers.
 
The GAO is gathering provider information for two reports requested by several Senators and Representatives. The first report, which is expected out in the spring, will focus on the process of audits outlining the responsibilities and requirements of the different Medicare contractors. The second report, expected in the summer, will discuss specific issues and recommendations of the GAO on the Centers for Medicare and Medicaid Services (CMS) oversight of the wide range of auditors now in place.  
 
Key issues raised in the VNAA-GAO meeting include: 1) Pre-payment audits are as troublesome as post-payment audits, 2) reviewers often deny claims because of their lack of training or understanding, 3) there should be opportunities to re-open a claim and avoid the Administrative Law Judge (ALJ) process when an improper denial is made, and 4) cash flow problems caused by audits are very serious and directly impact patient care.   
 
Prior to the GAO meeting, VNAA reached out to members through a survey to document problems providers are facing with regard to audits. In addition to member feedback, VNAA reached out to several state associations for their insights. Margaret Franckhauser, Executive Director of Central New Hampshire VNA and Hospice, also prepared a letter to send to GAO with her own agencies concerns, to read the letter please click here. Stay posted to Member Update for more news about audits and GAO.
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