HHS officials say they don't have the money or resources to clear their backlog of Medicare billing appeals by a court-imposed 2021 deadline.
Various restraints on Medicare's recovery audit contractors severely limited their ability to rectify improper payments last year, but hospitals have long welcomed a slowdown in auditing activity.
The federal government has until the end of 2020 to wipe out the backlogged glut of Medicare claims appeals from hospitals, a federal judge ruled this week.
The CMS has awarded five new contracts for Medicare's controversial recovery audit contractor program. Veteran contractor CGI Group will not return.
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.