Moving the HME Industry Forward

Legislative/Advocacy

HME Audit Key Continues to Show High Overturn Rates

• July 17, 2017

WASHINGTON, DC - The latest HME Audit Key survey results, running through the 1st Quarter of 2017, shows continued appeal determinations in favor of suppliers in several product categories, including overturn rates of 68% for respiratory products, 77% for ostomy, urological, wound care, and diabetic supplies, and 81% for NPWT devices and supplies. Other highlights from this round include:

• 37% of hospital beds, support surfaces, and manual wheelchair new patients were subject to MAC prepayment audit, compared to 11% for respiratory products and single-digit rates for other major categories.
• 68% of MAC prepayment denials were appealed.
• 71% of completed MAC prepayment audits were paid upon review.
• 67% of completed appeal determinations nationwide were in favor of suppliers.

See the complete report here. While these results are bringing the burdensome nature of the audit process into focus, we need more industry participation to be able to use this data to make our case to CMS and Capitol Hill.  Please support this effort by participating in the next round.

New Data Submission Round Opens July 17
The next HME Audit Key data submission period, covering the time period through the 2nd Quarter of 2017, opens Monday, July 17. Even if you haven't previously participated or have skipped rounds, you can still take part in this round.

Please help fight back against a broken audit and appeal system by participating in the HME Audit Key. Registration and participation is free, and is open to all suppliers, whether AAHomecare members or not. Register and submit your information at HMEAuditKey.org – and see additional info about the Audit Key here.

Brightree Tool Streamlines Audit Key Data Collection
Brightree customers have the option of printing a report from their My Files folder to answer many of the operational questions on the quarterly survey. To print the report, simply retrieve the report named AAH_Output.csv from the Inbox for the My Files page within Brightree, and open the report in a spreadsheet program like Microsoft Excel. Please see comprehensive guidance for using the Brightree report here: PDF version.

Supplier Numbers Drop 42% from 2013 to Now
Every quarter AAHomecare pulls the Medicare Supplier Directory to identify the number of “traditional” DME suppliers currently providing services to beneficiaries. The most recent review of the data found that the supplier numbers are steadily decreasing. According to AAHomecare’s estimates, there are roughly 6,086 unique suppliers and 9,810 locations nationally. Compared to 2013, the number of suppliers has decreased by about 42%.
 
Providers in mainline product categories such as hospital beds, NPWT, support surfaces, wheelchairs & accessories, respiratory products, and oxygen are included in this analysis.
 
Details on state by state counts can be found here.