With the help and support of Senator Burr, the NCMS and the Physicians Advocacy Institute (PAI) have pushed for legislation, which would fix the problems with the current Medicare audit process. NCMS and PAI support efforts to identify overpayments and prevent fraudulent claims, but want to ensure fairness and transparency. Last week’s meeting allowed important committee staff members to hear why this reform of the audit process is crucial to Medicare providers.
Dr. Monteiro and NCMS CEO Robert Seligson, who also attended the meeting, provided the staffers with material outlining the NCMS and PAI position on audit reform as well as a documentary film, “Guilty Until Proven Innocent: When Medicare Audits Cause Casualties” (see below), produced by the NCMS and PAI in 2012 and detailing the story of Dr. Monteiro’s RAC ordeal.
In Dr. Monteiro’s case, auditors initially demanded over $1 million in alleged Medicare overpayments. After appeal at the Administrative Law Judge level, 97 percent of the auditors’ findings were overturned. The costs and burden of the audit prompted the practice’s sale to the local hospital.
The Senate Finance Committee had asked meeting participants to answer three questions about the burdens presented by the current RAC audit process. Read the detailed answers from Dr. Monteiro and the PAI here.