From: The Honorable Paul A. Gosar

Sent By: trevor.pearson@mail.house.gov
Date: 6/4/2014

Deadline Extended

Help Improve Medicaid Audits Before it is Too Late

Deadline to sign extended to close of business Tuesday, June 10th
Endorsed by the American Dental Association

Current Signers (71): Michele Bachmann, Ron Barber, Dan Benishek, Rob Bishop, Marsha Blackburn, Bruce Braley, Cheri Bustos, Wm. Lacy Clay, Mike Coffman, Joe Courtney, Rick Crawford, Rodney Davis, Charles Dent, Tammy Duckworth,Renee Ellmers, Elizabeth Esty, Jeff Fortenberry, Lois Frankel, Tulsi Gabbard, Jim Gerlach, Chris Gibson, Paul Gosar, Sam Graves, Michael Grimm, Colleen Hanabusa, Greg Harper, Joe Heck, Sheila Jackson Lee, David Joyce, Doug LaMalfa, Doug Lamborn, James Lankford, Robert Latta, Tom Latham, David Loebsack, Billy Long, Cynthia Lummis, Thomas Massie,Betty McCollum, David McKinley, Mark Meadows, Luke Messer, Mike Michaud, Markwayne Mullin, Rich Nugent, Alan Nunnelee, Pete Olson, Collin Peterson, Mike Pompeo, Bill Posey, Phil Roe, Todd Rokita, Illeana Ros-Lehtinen, Keith Rothfus, Matt Salmon, David Scott, Mike Simpson, Kyrsten Sinema, Albio Sires,  Jason Smith, Chris Stewart, Steve Stivers, Lee Terry, Scott Tipton, Juan Vargas, Pete Visclosky, Ann Wagner, Brad Wenstrup, Lynn Westmoreland, Joe Wilson, and Rob Woodall.

Dear Colleague,

Please join me in sending a letter to the Department of Health and Human Services voicing our concerns about the implementation of the Recovery Audit Contractor (RAC) Program and potential negative impacts on physicians and dentists.  As we have seen, there have been significant problems associated with the Medicare RAC program since its launch in 2010. We are beginning to see similar problems in the states as they begin to implement the Medicaid RAC program.

Audits are a means to identify improper payment and instances of fraud within the Medicare and Medicaid programs.  Although a noble mission, the government tasked private entities, called Recovery Audit Contractors, with identifying and collecting improper payments made in the Medicare fee-for-service (FFS) program.  RAC auditors are paid on a contingency basis, which encourages the application of punitive damages at the expense of finding and correcting fraudulent activity.

As we have seen, RAC audit decisions are being overwhelmingly overturned by the Department of Health and Human Services Office of Medicare Hearings and Appeals (OMHA) after years of costly defense on behalf of accused health care providers.  In fact, earlier this year OMHA released a notice that its workload has grown by roughly 184 percent, and that its backlog of appealed audits has grown to 460,000 in just under two years – preventing practitioners from receiving swift reprieve from erroneous fraud accusations.  It is clear that we need substantial RAC audit reform.

Just as many of our colleagues have highlighted the substantial concerns with Medicare RAC audits, with the new implementation of Medicaid RAC audits, we have the opportunity to work toward a better process before this program is rolled out nationwide.  I encourage you to join me and sign on to this letter.  To become a signatory, please contact Trevor Pearson, (trevor.pearson@mail.house.gov) or Steven Smith (steven.smith@mail.house.govx52315 in my office. The new deadline to sign on is close of business Tuesday, June 10th. Text of the letter is below.

Sincerely,

Paul A. Gosar, D.D.S.
Member of Congress