PAI Pushes for RAC Audit Reform

The Physicians Advocacy Institute (PAI) submitted additional comments this month on the Audit & Appeal Fairness, Integrity and Reforms in Medicare (AFIRM) Act to Senator Orrin Hatch, Chairman of the Senate Finance Committee, which passed the AFIRM Act earlier this year.  There is growing consensus that significant reforms are needed to address the serious problems in the Medicare audit and appeals processes to address inaccurate audit findings and the costly, time-consuming appeals process. The letter, which was from North Carolina Medical Society (NCMS) CEO Robert W. Seligson, who also is the President of PAI outlines specific ways to revamp the Medicare audit process. Read the letter.

The NCMS has been pushing for such legislation for years. Working closely with Sen. Richard Burr (R-NC), NCMS Past President Robert Monteiro, MD, testified in March 2014 before a special meeting of key Senate Finance Committee staff hosted by Sen. Hatch. Dr. Monteiro detailed his practice’s experience with a flawed RAC audit and the financial hardship it caused.

In the US House of Representatives, Rep. George Holding (R-NC) introduced a RAC reform bill called “The Fair Medical Audits Act of 2015.” The bill reflects years of effort by the NCMS working with the PAI to address many concerns physicians throughout the country have with the extraordinary lack of transparency and expensive, time-consuming and often unfair processes plaguing the current Medicare audit program.


Share this Post