Monday, May 6, 2024

Follow Up to Audit Discrimination Article

Sara Beck

 Hello again,
Iwanted to briefly follow up regarding my recent audit discrimination post.  Many have asked that I summarize the responsethat I have received.  First, I wouldlike to thank the hundreds, upon hundreds, of providers, manufacturers,legislative officials, and organizations associated with the medical communityfor your encouraging and profound responses to my article.  The reaction has been nothing but positiveand I have been given an astounding response that makes me proud to be a partof this remarkable profession.  Iwant to clarify one thing: my article was written based on fact and evidence.  Assumptions, opinions and accusations werenot used to write the article.  Theevidence that proves that article’s truth is uncontested and came directly fromthe source.  Any attempts to question itsvalidity should be directed to CMS.  Also, there has been talk of CMS’s new ADR limit policy as apossible reason for the audit discrimination. For one, my FOIA data dates back to 2009.  Second, it is true that CMS implemented arule which began on April 15, 2013 that limits the number of AdditionalDocumentation Requests (ADR).  But, therehas been a misrepresentation of what the rule actually does.  The rule states: “The maximum request amountis PER CAMPUS. The definition of campus is one or more facilities under thesame Tax Identification Number (TIN) located in the same AREA.”  The rule goes by CAMPUS (zip code/area), notjustTIN. So, it does not explain the discrepancy.Early last year, I brought this factual information to manyentities, providers and organziations and gave everyone fair opportunity to getinvolved and facilitate a solution for the members and patients of the O & Pcommunity.  Although, some disregarded methrough written communications, and some I have not had a chance to get incontact with, I want to make it known that the door is still open.  No bridges have been burned and I warmlywelcome anyone or any organization to contact myself, or OPGA, if they feel theneed to help in finding a proactive and positive solution.  We are working together as one profession,not against each other.  Again, thank you to everyone who responded to the article withkind and encouraging words. A special thank you to the OPGA staff for their outstandingsupport and admirable dedication to O & P.  We are continuing to work on finding a constructivesolution and answer to this injustice. But we need you; we need your voice,your story.  Please contact myself or OPGA. It’s time to take a stance.  If you are not part of the solution, you arepart of the problem.  Let’s get involved,get loud and be heard.  So we can getback to making legs.   Kind regards,

Sara Beck
Appeals Specialist
San Joaquin Orthotics & Prosthetics
2211 N. California Street
Stockton, CA  95204
209.932.0170
209.932.0172 Fax
RAC Support

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