Recovery Audit Contractor (RAC) news and information

Abuse of prescription painkillers causes more fatalities than heroin and cocaine combined. Yet efforts to stop the Medicare fraud that puts drugs on the black market aren't working as they should.
FULL STORY »

Two House members are again pushing legislation aimed at improving the Recovery Audit Contractor program, which the lawmakers say causes unnecessary costs and bureaucratic headaches for hospitals.
FULL STORY »

The American Hospital Association is not backing down from its lawsuit against the CMS that claims healthcare providers have lost hundreds of millions of dollars in reimbursements through a billing policy that unfairly penalizes providers who submit incorrect Medicare claims.
FULL STORY »

A sweeping new CMS rule to address hospitals' complaints that they have been denied hundreds of millions of dollars will not lead the American Hospital Association to drop its lawsuit over the issue.
FULL STORY »

Investor-owned healthcare systems have been adding to their legal ranks and boosting self-policing in an attempt to get one step ahead of heightened regulatory activity around fraud and abuse.
FULL STORY »

The popular notion in healthcare is that the most aggressive fraud hunters—known as “zone program integrity contractors,” or ZPICs—focus on small players. That idea is wrong.
FULL STORY »

Read an edited excerpt of the transcript for Modern Healthcare's Dec. 18 editorial webcast, “Avoiding the RAC Trap,” hosted by Modern Healthcare reporter Joe Carlson.
FULL STORY »

Read an edited excerpt of the transcript for Modern Healthcare's Dec. 18 editorial webcast, “Avoiding the RAC Trap,” hosted by Modern Healthcare reporter Joe Carlson.
FULL STORY »

A little-noticed provision in the fiscal-cliff package will give Medicare officials more time to take back an estimated $500 million in payments made to hospitals and physicians.
FULL STORY »

The GAO says the CMS could potentially save tens of millions of dollars a year by standardizing how Medicare payments to hospitals and physicians are audited before the bills are paid.
FULL STORY »