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Recovery Audit Contractor (RAC) news and information

Vital Signs
Some providers already taking Medicare's RAC appeal deal
By Bob Herman | September 11, 2014
It's been about two weeks since the CMS told hospitals and health systems it would pay a portion of appealed inpatient-status claims, and at least a few have taken Medicare up on its offer.
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News
Former LifePoint exec Sherman named CFO of HMS
By Bob Herman | September 09, 2014 | Basic Web Basic Web Subscription Details
HMS Holdings Corp., a major player in Medicare’s auditing space, has named Jeff Sherman CFO, effective Sept. 8.
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Magazine
CMS offers deal in lieu of RAC appeal
By Bob Herman | September 06, 2014 | Print Magazine Print Magazine Subscription Details
The CMS has made a tempting offer to hospitals as a way to clear its heavily backlogged Medicare appeals process, and many may take it to save time and money.
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Magazine
Medicare needs to end observation status for patients
By Dr. Chris Edwards | September 06, 2014 | Print Magazine Print Magazine Subscription Details
Every time I see a story about the issue of observation services I feel compelled to reply. Quite frankly, it is the existence of observation services that is actually the problem. Any solution has to include the elimination of observation.
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News
CMS offers holiday sale on audit appeals
By Modern Healthcare | August 30, 2014 | Basic Web Basic Web Subscription Details
In a pre-Labor Day weekend bid to lower its backlog of contentious payment disputes, the CMS late Friday offered to pay hospitals 68% of all medical claims appealed by the service providers after having been rejected by outside auditors.
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Magazine
Hospitals hope for relief from CMS' two-midnight rule
By Bob Herman | August 23, 2014 | Print Magazine Print Magazine Subscription Details
Lots of people have ideas about how to change Medicare's unpopular two-midnight rule for short patient stays. But based on the public comments the CMS solicited in May, there's no consensus on what a new policy should look like.
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News
GAO finds Medicare's audit contractors may duplicate efforts
By Bob Herman | August 14, 2014 | Basic Web Basic Web Subscription Details
The CMS' audit contractors may overlap duties and hammer hospitals with multiple reviews of the same payment claims, according to a new Government Accountability Office report that echoes concerns the provider community has voiced for years.
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News
Controversial Medicare recovery audits make limited return
By Paul Demko | August 05, 2014 | Basic Web Basic Web Subscription Details
The CMS is restarting audits of Medicare fee-for-service claims on a limited basis. The program has been dormant since June 1 when current audit contracts expired.
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News
Medicare's audit contractors are failing, say lawmakers and hospitals
By Virgil Dickson | July 09, 2014 | Basic Web Basic Web Subscription Details
Providers and members of Congress are pushing the CMS to rethink its tactics for reducing the number of improper Medicare claims.
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News
Hospitals sue HHS over sluggish RAC appeals
By Joe Carlson | May 23, 2014 | Basic Web Basic Web Subscription Details
Administrators at Baxter Regional Hospital in Mountain Home, Ark., say they have so much money tied up in Medicare appeals that they can't afford to replace the roof over their surgery department or buy new beds for their intensive-care unit. So they joined two other providers and the American...
FULL STORY »
 

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