Fox Rehabilitation, a health care provider located in Cherry Hill, New Jersey, “provides physical, occupational and speech therapy services – whether in a house, apartment, senior living community, adult medical day care, or outpatient clinic.”
Its CEO, Tim Fox, has reported on the costs of Medicare audits. Here are some of the observations:
- Fox Rehabilitation employs 905 persons, with 705 clinicians “who visit patients in their homes in eight states”.
- Win rate on audit appeals: 85% are won at the third level of appeal.
- Expected revenue 2014 is $90 million.
One of the big problems is compliance with the massive amount of document requests from audits. The cost is so high that Fox Rehabilitation was forced to cut staff in other areas of the company. The increased audits with a reduction of -15% in Medicare payments drove the company to lay off 62 employees. IT also had to reduce the payments to its therapists.
Reference: (1) Harold Brubaker, Costs of expanded audits aimed at Medicare fraud hit health-care firms, Philly.com, posted 28 July 2014; Jane Antonio, Senate committee pushes for RAC reform: Overwhelmed provider calls audits ‘a brutal spanking’, FierceHealthPayer AntiFraud, blog, 28 July 2014.