Physicians Advocacy Institute (“PAI”) Endorses the Fair Medical Audit Acts of 2015





Today, U.S. Representative George Holding of North Carolina introduced "The Fair Medical Audits Act of 2015." The Physician Advocacy Institute ("PAI") strongly endorses this legislation, which would address fundamental concerns that physicians have with regard to the extraordinary lack of transparency and expensive, time-consuming and often unfair processes that plague the current Medicare audit program. 

Representative Holding declared it time to fix the broken RAC program, stating: "Put simply, patients achieve the best health outcomes when practicing physicians do just that – practice medicine. My bill will bring transparency and fairness to the audit process so doctors can spend more time caring for their patients and less time proving their innocence. Medicare frauds must be found and severely punished but not at the cost of the independent practice of medicine."

Currently, Medicare pays recovery audit contractors or "RACs" on a contingency basis to find overpayments to health care providers, providing these contractors with undue monetary incentives to audit doctors. This legislation would establish incentives for RACs to make more accurate audit findings and increase educational efforts to help physicians avoid common mistakes."

Since its inception in 2006, the PAI has been committed to advocating for more fair and transparent medical audits. Robert W. Seligson, MBA, MA, President of the Physicians Advocacy Institute and EVP/CEO of the North Carolina Medical Society, lauded the legislation, noting: "It is time to address fundamental problems that have contributed to the backlog of audit appeals and caused a great deal of unnecessary expense and confusion for physicians nationwide. We commend Congressman Holding for his leadership on this critically important issue." 

Representative Holding is a member of the House Ways and Means Committee, which has jurisdiction to consider legislation to reform the RAC program.

For more information, please contact PAI Executive Vice President, Kelly Kenney, at 312-543-7955 or k2strategiesllc@gmail.com.