Hospitals oppose proposal to tweak Medicare RAC appeals process

By Virgil Dickson  |  September 01, 2016

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.

Ruling gives hospitals hope on RAC appeals backlog

By Lisa Schencker  |  February 09, 2016

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.

Don't overlook impact of consumer-driven healthcare, and other letters

By Modern Healthcare  |  June 20, 2015

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.

RAC program requires major changes for improved transparency

RAC program requires major changes for improved transparency

By Dr. Ann Sheehy  |  June 09, 2015

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...

Trade group seeks RAC reform

By Lisa Schencker  |  March 21, 2015

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.