The recent memorandum sent to Medicare appellant from Chief Administrative Law Judge Nancy Griswold detailing the incredible appeals backlog, and subsequent decision to suspend assigning dates for new ALJ hearings for the next 24 months, has created a fervor of activity and shined a bright light on the shortcomings of current Medicare audit programs.
Many Republicans and Democrats in congress are hearing from virtually every type of Medicare provider, including physicians, physical therapists, durable medical equipment suppliers, complex rehab providers, pharmacists, orthotists and prosthetists and, of course, hospitals. The American Hospital Association has been very active in promoting the audit impact on their membership. Orthotic and Prosthetic Group of America has sent a letter in response to Judge Griswold and has reached out to several senators and members of congress in recent weeks to ensure the fact that CMS is denying Medicare providers due process by not maintaining an adequate and timely appeals process is brought to their attention. The American Orthotic and Prosthetic Association also recently contacted CMS on the issue on behalf of their members and manufacturers.
The recent memo from Judge Griswold also provided information about an Office of Medicare Hearing and Appeals Forum (OMHA)to discuss potential remedies to the nearly half a million claim appeals backlog. OPGA Government Relations has registered for the event and plans to attend.
OPGA is working to bring stories from independent orthotic and prosthetic practices about the incredibly negative impact Medicare audits are having on your business; also how audits have created delays and changes in care for beneficiaries. If you have a story you would like delivered to OMHA staff at the forum, please email firstname.lastname@example.org
OPGA will provide updates on the content of the forum as soon as they are available, so stay tuned to the Government Effects Blog for more information.