Oversight of Medicare Audit Contractors, Surety Bond Comments

Lost in the media attention surrounding the Supreme Court ruling on the Affordable Care Act was the fact that key members of both parties, including: Senators Hatch, Baucus, Coburn, Carper, Grassley and Congressmen Waxman, Stearns, Boustany, Lewis and DeGette, recently sent a letter to The Government Accountability Office seeking a study of the Centers for Medicare and Medicaid Services (CMS) relating to the oversight and coordination of contracted Medicare auditors.

Momentum on the issue of oversight and coordination for Medicare auditors had been building in previous weeks, but the official letter was sent shortly after The VGM Group, OPGA’s parent company, hosted a webinar featuring Mark Higley from the VGM Group, Edward Vishnevetsky, an attorney with Munsch Hardt Kopf & Harr, and Kimberly Brandt, chief health care investigative counsel for the minority staff of the U.S. Senate Finance Committee to discuss issues related to DMEPOS audits and auditors last month. The Senate Finance Committee announced they would seek comments from the DMEPOS industry on their experience with auditors and what their recommendations would be to help curb abuse of these Medicare-contracted entities.  

Also last month, VGM Group was part of a group of DMEPOS industry stakeholders that provided comments to CMS on issues related to the recently controversial surety bond program as it relates to recoupment of overpayments for Medicare. The comments focused on the following:

Only allow the DME MACs to trigger a surety bond if a threshold dollar amount is reached.

  • Provide better notice to HME providers when a surety bond is about to be triggered.
  • Give surety bond companies more time to notify HME providers that their bonds are about to be triggered so that the HME companies can take corrective action. MORE

Contact OPGA with any questions you may have about the surety bond program or VGM/OPGA’s efforts on behalf of the DMEPOS industry on the oversight of Medicare-contracted auditors.

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