Regarding the article CMS announces RAC program companies:
The concept here is good, however, the CMS has failed miserably in placing proper oversight on these contractors. While the existing contractors have made significant gains in recovery, they are also responsible for a significant increase in the appeals from doctors who feel that the decisions are unfair. Several physician offices have been subjected to 100% error ratios based entirely on the fact they did not dot every i and cross every t in their documentation. While this is a technical violation of Medicare documentation procedures, it is not a fraud or abuse issue. The services were rendered and in the manner billed to the system. The doctor should not be made to pay back all money received based on his failure to initial every page of his record especially in a one-provider practice.
The CMS needs to set the guidelines and clearly differentiate what is a recovery-based complaint and what items need to be addressed with the doctors through an educational system to ensure that they are meeting each and every little point required.
R.L. RamsdellExecutive director Multidisciplinary Academy of Affiliated Medical ArtsHenderson, Nev.
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