Bill seeks to ease Medicare audit burden

A bill from Reps. Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) would cap the number of document requests possible during audits of Medicare providers suspected of improper payments.

Graves and Schiff reintroduced the Medicare Audit Improvement Act on Tuesday, citing the challenges for hospitals buried in requests from investigators known as Recovery Audit Contractors (RACs).

"Doctors and nurses should be focused on caring for patients, not trying to comply with the ever-increasing requests for documents," Graves said in a statement. 

"My bill would put in place common-sense reforms allowing auditors to still conduct adequate oversight of billing problems without an open-ended invitation from [the Medicare agency] to continually bombard hospitals."

The measure would limit the number of "additional document requests" to two percent of hospitals claims, with a maximum of 500 per 45 days. It would also penalize auditors that ignore basic audit requirements and courtesies. 

A non-profit anti-fraud group criticized the bill. 

“While we have not had an opportunity to review the legislation in its entirety, we are discouraged that once again efforts are afoot in Congress that would seek to take the teeth out of recovery programs that have returned more than $3.4 billion to the Medicare trust fund since 2009,” said Amanda Keating with the American Coalition for Healthcare Claims Integrity.

Graves and Schiff announced the legislation at a meeting of the American Health Information Management Association. The bill was previously introduced last October. 

—This post was updated with the Keating quote at 2:14 p.m.

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