AOPA Clarifies: CMS Phasing in Audit Resumption
July 22, 2020
On July 10, the Centers for Medicare & Medicaid Services (CMS) announced the resumption of certain audit activity beginning on August 3. However, through involvement on the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) Advisory Councils, the American Orthotic & Prosthetic Association (AOPA) learned that CMS will not restart all audits on August 3, but will implement a phased approach to allow suppliers time to prepare and adjust.
The audits will begin with limited DME MAC-based post-payment reviews and will only involve claims with dates of service prior to the beginning of the declared public health emergency on March 1.
CMS did not provide a timeframe to AOPA for the next phase or for the renewal of audit activity through the Targeted Probe and Educate program, Recovery Audit Contractor audits, or Supplemental Medical Review Contractor audits.
CMS reiterated that the DME MACs may allow for flexibility with extensions and the cancelling of audits based on an individual supplier's ability to complete the audit.