AHCA Sets Up Clearinghouse For Audit-Bitten Providers; Obama Seeks $100M For Brain Research
Bill Myers
4/3/2013
The American Health Care Association (AHCA) has set up a clearinghouse for providers worried that they could be on the wrong side of the Obama administration’s Recovery Audit Program, the group told its members Tuesday.
Federal law has required the Centers for Medicare & Medicaid Services (CMS) to hire contractors to audit all therapy claims above $3,700. For providers in 11 states—California, Florida, Illinois, Louisiana, Missouri, Michigan, New York, North Carolina, Ohio, Pennsylvania, and Texas—those audits will take place before payments are released.
“Called ‘manual medical review,’ and required by Congress through the end of 2013, CMS has said that it wants to know about any glitches in the review process immediately,” AHCA said. “Thus, AHCA has taken steps to continuously channel providers’ problems with the process to CMS through the AHCA Manual Review Clearinghouse at
manualreview@ahca.org. If a provider is facing a glitch or a problem that it cannot get resolved, we ask that the provider send the problem to the clearinghouse at manualreview@ahca.org.”
“On the positive side of the manual review process,” AHCA added, “CMS is requiring RAs [Recovery Auditors] to complete prepayment reviews within 10 days, and we especially want to hold them to this time frame.”
In other news Tuesday, the Obama administration announced that it was seeking some $100 million to fund brain research, including research on Alzheimer’s disease and other forms of dementia. The money will go to various programs around the government, including defense agencies, to map the human brain.
The program is called, aptly enough, “BRAIN.” It stands for Brain Research Through Advancing Innovative Neurotechnologies, and it won immediate praise from the Alzheimer’s Foundation of America.
“The BRAIN Initiative is an exciting development and a potential game changer in unlocking the mysteries of Alzheimer’s disease,” foundation acting Chief Executive Officer Carol Steinberg said in a public statement released Tuesday. “This far-reaching project holds the promise of providing deeper insights into concepts such as cognitive reserve, ultimately leading to ways to treat or even prevent Alzheimer’s disease. It is just the shot in the arm that both scientists and families need right now, especially in light of flat research funding for Alzheimer’s disease and the threat of this devastating disease overwhelming more and more Americans.”