The Federation of American Hospitals is warning that a proposed rule regarding new Medicaid recovery audit contractors (PDF) could allow too much state flexibility and produce the same problems seen during an earlier demonstration project.
FAH wary of variation in Medicaid RAC program
The Patient Protection and Affordable Care Act required states to establish Medicaid RAC programs by submitting state plan amendments to the CMS by Dec. 31 and implementing them by April 1. A RAC program already exists under Medicare.
However, the federal regulations proposed in November would allow the states to customize their Medicaid RAC programs in some ways. Such variations, according to comments on the proposed regulations submitted by Chip Kahn (PDF), president and CEO of the federation, could increase the regulatory burden on healthcare providers and endanger the accuracy and transparency of the RAC process. For instance, some states could require Medicaid providers to submit to nearly unlimited requests for data from RAC audits, even if such data was already provided during another recent audit.
“During the demonstration project, providers were surprised with the overwhelming record demands from the RACs and suffered huge administrative burdens in timely producing the requested records,” Kahn wrote.
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