RAC CPAP/BIPAP Audits in Jurisdiction D

 The Medicare Recovery Audit Contractor (RAC) in Jurisdiction D has been recouping money for CPAP and supplies if the provider did not have a sleep test PAID FOR by Medicare.  Walt Gorski of AAHomecare reported great news yesterday that CMS staff has indicated that this was a misinterpretation of the policy and that they will not be continuing with automated audit review.  However, if CMS does suspect that there is a problem, they will use discretion to conduct a complex review.

 

CMS staff indicated that they would be refunding money that has been collected due to the misapplication of the policy.

 

A big thank you goes to Region D DAC's Respiratory Team leader Kelly Riley from MED Group and other members of the DAC Respiratory Team including Rose Schafhauser MAMES Executive Director, and Sheila Roberson, our DAC Chair put in a lot of work on this issue.