WAIT TIME FOR AUDIT APPEALS INCREASED BY NEARLY 25% IN 2015

WED, AUGUST 26, 2015

WASHINGTON, DC

The American Association for Homecare (AAHomecare) today released an analysis of the Office of Medicare Hearing and Appeals (OMHA) appeals backlog, using data available on the OMHA website. The analysis has uncovered that in spite of reports from OMHA indicating improvement, in the first half of 2015, the wait time has increased by nearly 25 percent, with June posting an average processing time of 714.9 days.

“It is painfully obvious that this system is broken, but no measures are being taken to fix the root of the problem,” said Kim Brummett, vice president of regulatory affairs at AAHomecare. “DMEPOS claims are different, and need to be treated as such. Home medical equipment providers are dealing with the same patient and same service/item on an ongoing basis over a period of time. When the first claim is denied, all of the subsequent claims for the same patient and service are denied. However, when the previous claim is overturned, it does not mean that any other claims for the same patient and same service will be paid/overturned at any level. This cycle traps a large volume of claims in a system that cannot handle them properly.” 

Please see pdf version of full release linked below for complete release, including additional details and associated charts.

Complete release, with additional details and graphics.

The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community that serve the medical needs of millions of Americans who require oxygen systems, wheelchairs, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org.