Becker’s Hospital Review: Medicare RACs, Hospitals Spar Over New Fraud Legislation


A bill that would reform Medicare recovery auditing practices has spurred tensions between hospitals and RACs.


“Last month, House Reps. Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) reintroduced the Medicare Audit Improvement Act. Under this bill, Medicare RAC record requests would be capped to 2 percent of hospital claims, with a maximum of 500 medical record requests every 45 days, among other measures.

The American Coalition for Healthcare Claims Integrity, a non-profit RAC supporter group, argued the bill would result in billions of taxpayer dollars in improper hospital payments. “The bottom line is that recovery auditors bring accountability and transparency to the Medicare program,” ACHCI spokesperson Amanda Keating told The Hill. “If you want to send Medicare crashing to the ground, letting improper payments run rampant is a surefire way to do that.”

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