Hospital associations say a CMS proposal to ease the backlog of denied Medicare claims by making tweaks to the recovery audit contractor appeals process could leave them with fewer opportunities to retain payment. Others say the proposal would let potentially untrained people make the decisions.
A year after settling billing disputes with 2,022 hospitals for 68 cents on the dollar to clear a huge backlog of audit appeals, the government has revealed who got paid and how much.
The federal government has a backlog of more than 800,000 appeals from healthcare providers challenging denied Medicare claims, most of them generated by the program's recovery audit contractors, or RACs.
Hospitals persuaded a federal appeals court to give new life to their legal fight to force HHS to work more quickly through a backlog of disputed findings by Medicare's controversial recovery audit contractors.
The CMS is kicking off the search process for new Medicare recovery audit contractors. The RAC program has been a source of controversy for the agency.
Regarding the recent Comment/Guest Expert, “Higher employee cost-sharing could undermine job-based coverage system”, the Commonwealth Fund's Dr. David Blumenthal addressed many salient facts and issues relating to employer-based health insurance in his editorial.
Recovery auditors have returned an estimated $5.4 billion to the Medicare trust funds, yet providers have argued that the contingency-fee-based RAC program is fraught with inaccurate auditing and myriad inefficiencies. Such opposing views reflect a major issue plaguing the program: lack of...
Members of the U.S. Senate Special Committee on Aging called on the CMS during a hearing Wednesday to make changes to Medicare's recovery audit contractor program, which some providers have identified as a driving force behind the rise in observation stays in recent years.
The Senate Finance Committee is scouting for ideas that might break a massive logjam of denied Medicare claims appealed by providers and suppliers.
The American Orthotic & Prosthetic Association is proposing a change to Medicare's recovery audit contractor program that it contends would keep providers from suffering devastating financial losses while appealing disputed claims.
The American Orthotic & Prosthetic Association is proposing a change to Medicare's recovery audit contractor program that it says would keep innocent providers from suffering devastating financial losses while appealing disputed claims.
The Medicare Payment Advisory Commission is tentatively backing a package of recommendations that will both overhaul how recovery audit contractors operate and discourage hospitals from billing for too many short inpatient stays.