RAC Integration for Medicare Advantage Audits

Section 6411(b) of the Patient Protection and Affordable Care Act of 2010 (PPACA) requires the expansion of the Recovery Audit Contractor (RAC) program to Medicare Part C. While we may refer to either MA as Medicare Advantage (or a more accurate acronym, MAO, for Medicare Advantage Organizations), the simple fact is that the RACs (or Read more about RAC Integration for Medicare Advantage Audits[…]

CMS proposes waiting longer to pay Medicare Auditors

Medicare officials want to make it harder for their recovery-audit companies to collect fees for auditing hospital and doctor bills. Earlier this week, the Government Accountability Office gave the CMS the go-ahead to make the change despite protests from the auditors. Recovery auditing is a major point of controversy among Medicare providers. The four companies Read more about CMS proposes waiting longer to pay Medicare Auditors[…]

New RAC Audits Posted

New RAC Audits Posted Region A Performant Recovery, the recovery audit contractor (RAC), posted a complex review for automatic external defibrillators on December 26 that will specifically look at claims billed without an indication supporting medical necessity as described in the NHIC Local Coverage Determination (LCD) L13613 and related article (A23905). This Audit impacts providers Read more about New RAC Audits Posted[…]

Hospitals Voice Frustration to Senators About Burdensome RAC Audits

On June 25, 2013, the Senate Committee on Finance heard testimony from hospital representatives and a recovery audit contractor (RAC) representative regarding burdensome audit procedures. RACs were created to identify improper payments made to Medicare Parts A and B providers and suppliers. However, hospitals are finding that the audits significantly increase hospital burdens without seeming Read more about Hospitals Voice Frustration to Senators About Burdensome RAC Audits[…]

Senate Finance Committe Warns of Audits Hurting DME Providers with Red Tape

In a Senate Finance Committee hearing this past Tuesday, Chairman Max Baucus (D-Mont.) called on Congress and the administration to strengthen a key Medicare program that saves taxpayers millions of dollars each year by rooting out improper payments to health care providers. However, the Senator warned that the initiative, the Medicare Recovery Audit Contractor (RAC) Read more about Senate Finance Committe Warns of Audits Hurting DME Providers with Red Tape[…]