Update on CMS Resumption of Medicare Audits

On July 10, we informed you that the Centers for Medicare and Medicaid Services (CMS) announced the resumption of certain audit activity beginning on August 3, 2020.

AOPA, through its involvement on the DME MAC Advisory Councils has since learned that CMS has clarified the scope of the audits that will resume on August 3. CMS will not be restarting all audits on August 3, but instead due to the continued Public Health Emergency (PHE) will be implementing 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 PHE on March 1, 2020. 

As of now CMS did not provide a timeframe for the next phase or for the renewal of audit activity through the Target, Probe, and Educate (TPE) program, RAC audits or SMRC audits. CMS also reiterated that the DME MACs may allow for flexibility with extensions and the cancelling of audits based on individual supplier’s ability to complete the audit.
AOPA will continue to monitor the resumption of CMS audit activity and provide you with timely updates.

Questions may be directed to Joe McTernan at jmcternan@AOPAnet.org or Devon Bernard at dbernard@AOPAnet.org.