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Recovery Audit Contractor (RAC) news and information

News
RACs recouped $3B for Medicare in 2013
By Bob Herman | September 29, 2014 | Basic Web Basic Web Subscription Details
Medicare's recovery auditors returned more than $3 billion into the program's coffers last year, a new government report shows. And providers that appealed those audits won less than 1 in 5 tries. While the RAC trade group cheered the report, it isn't quelling provider criticism of the RAC program.
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Vital Signs
Why one congressman wants to scrap Medicare's hospital appeals deal
By Bob Herman | September 19, 2014
The CMS has been pretty quiet about its Medicare appeals settlement for hospitals, and now a congressman wants the agency to retract the offer altogether.
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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.
FULL STORY »
 

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