House Subcommittee Focuses on RAC’s in hearing, Duckworth stands up for small providers

Two major subcommittee meetings were held in the House of Representatives today on Medicare waste, fraud and abuse. One of the issues hightlighted in both hearings was the conduct of RAC auditors and the impact they are having on providers large and small. The House Government Oversight and Government Reform Health Subcommittee heard testimony from The Center for Program Integrity, the GAO and the HHS OIG on efforts to control waste fraud and abuse within the Medicare program.

Subcommittee member Congresswoman Tammy Duckworth, herself a double amputee veteran, questioned the CMS witnesses on the impact of these RAC policies on small medical providers, specifically the orthotic and prosthetic providers that have worked to bring her back to a sense of normalcy in her life. Take a look at the link to video of the testimony to see members of congress putting the words of small orthotic and prosthetic providers into action. OPGA, our network of independent O&P facilities and the entire O&P profession have worked hard over the past several years to engage Congresswoman Duckworth on the audit issue and that work seems to be paying off in 2014.

Congresswoman Tammy Duckworth (D-IL) said “It seems blaintly unfair and unAmerican to take these folks money and not give them the right to due process.” She then addressed the panel asking if CMS has any plans to restore fairness to our providers.

View the video here: Congresswoman Duckworth begins at the 1:06:44 mark.

Additional highlights include:

Congresswoman Michelle Lujan Grisham (D-NM) spoke about the difficulties that smaller providers have complying with regulations that the RACs require. She commented, “I have some serious concerns that the current system of post payment audits by RACs is resulting in a significant burden on some providers, particularly smaller providers… They do not have the luxury of waiting months for their payments adjudicated.” She also expressed her concerns about the beneficiaries saying “this is a Lose-Lose situation for everyone.”

Congressman Mark Meadows (R-NC) address the panel about the twenty-eight month backlog. He said it would take close to ten years to work through all these backlogged audits. Under this process, “We have a policy that says your guilty until proven innocent, ” he said.

Chairman James Lankford (R-OK) said “We’re losing the good guys in the fight. That is going to hurt us in the long term.” 

There was also a Ways and Means hearing today with the Health Subcommittee on Current Hospital Issues in the Medicare Program. This hearing also spent considerable time talking about the undue burden RAC auditors are placing on providers, in this care hospitals.

See O&P advocate Chairman Kevin Brady’s prepared opening statement here.

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