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Category : Press Release

RAC Facts: Frequent Filers Continue to Overwhelm Medicare Appeals Process

Frequent Filers Continue to Overwhelm Medicare Appeals Process Despite CMS recently offering providers a settlement incentive to clear the backlog of Medicare appeals claims, new estimates show that providers are still filing appeals at a rapid rate in an attempt to game the system. The Office of Medicare Hearings and Appeals (OMHA) now reports that the backlog of appeals cases will surpass 1 million claims by the end of this month. While recently testifying before Congress, Chief Administrative Law Judge […]

RAC Facts: More than $10 billion returned to Medicare Trust Fund

More than $10 billion returned to Medicare Trust Fund The CMS Medicare Fee-for-Service (FFS) National Recovery Audit (RA) Program reports for the second and third quarters of 2015 show Recovery Audit Contractors (RACs) have returned a total of more than $10 billion to the Medicare Trust Fund since the program began in 2006. Additionally, RACs have returned more than $800 million in underpayments to Medicare providers for services that were initially under billed.  Due to restraints placed on the program, […]

Mary Hitchcock Memorial Hospital Overbilled Medicare $1.4 Million

FOR IMMEDIATE RELEASE                                                 August 10, 2015             CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Mary Hitchcock Memorial Hospital Overbilled Medicare $1.4 Million Washington, D.C. – A report released this week by the Office of Inspector General found that Mary Hitchcock Memorial Hospital in Lebanon, New Hampshire overbilled Medicare by $1,393,198. According to the OIG, the hospital improperly billed […]

More than $10 billion returned to Medicare Trust Fund

FOR IMMEDIATE RELEASE CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 More than $10 billion returned to Medicare Trust Fund More work needed to prevent program bankruptcy in 2030 Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) Medicare Fee-for-Service (FFS) National Recovery Audit (RA) Program reports for the second and third quarters of 2015 show Recovery Audit Contractors (RACs) have returned a total of more than $10 billion to the Medicare Trust Fund since the program began in 2006. Additionally, […]

Medicare Celebrates 50th Anniversary, Americans Concerned for Program’s Future

FOR IMMEDIATE RELEASE   CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995  Medicare Celebrates 50th Anniversary, Americans Concerned for Program’s Future Washington, D.C. – On July 30, 2015, Medicare will turn 50 years old. As the program celebrates this milestone, many Americans – and Medicare Trustees – are concerned about its financial future. A startling Medicare Trustee report has warned that the Medicare Trust Fund may not be around to support future generations, predicting that the fund will be insolvent in just 15 […]

RAC Facts: Medicare’s 50th Anniversary: What Does The Future Hold?

Medicare’s 50th Anniversary: What Does The Future Hold? Medicare is celebrating its 50th anniversary this month, but when the program reaches the age at which most beneficiaries enroll – 65 – it may be bankrupt. Over the past five decades, Medicare has had a tremendous impact: Today, Medicare covers 55 million Americans who are over 65 years old or disabled. The program has contributed to a five-year increase in life expectancy at age 65. Now, only 2% of Americans over 65 […]

RACFacts: AFIRM: What You Need To Know

AFIRM: What You Need To Know The Senate Finance Committee is to be congratulated for its important work navigating a complicated system and undertaking much needed changes to the Medicare appeals process, as reflected in the Audit & Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015. The Council for Medicare Integrity is encouraged by the Committee’s focus to reduce the now historically high of level of improper Medicare payments which have drained more than $46 billion from […]

RACFacts: How do RACs review claims?

How do RACs review claims? Have you ever wondered how Recovery Auditors look at Medicare claims? How do they decide what issues to review, and who actually participates in the review process? Recovery Auditors employ numerous staff from the medical field to assess claims – Medical Directors, Nurses, Coders and countless healthcare reimbursement experts. All three types of review outlined below are overseen by the auditor’s Medical Director. Following is a diagram that walks through the process that takes place […]

May Reports: Two Missouri Hospitals Overbilled Medicare $900k

FOR IMMEDIATE RELEASE                                                 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 May Reports: Two Missouri Hospitals Overbilled Medicare $900k Washington, D.C. – Two reports released in May 2015 by the Office of Inspector General found that Missouri hospitals overbilled Medicare $900,000. According to the OIG, Saint Luke’s Hospital of Kansas City improperly billed Medicare in 27 percent of claims, resulting in overpayments […]

RACFacts: Do You Know What RACs Can Audit?

Do You Know What RACs Can Audit? Recovery Audit Contractors (RACs) have returned nearly $10 billion in mis-billed taxpayer dollars to the Medicare Trust Fund over the past five years while reviewing less than 2 percent of Medicare claims. Despite this success, the waste-busting RAC program is essentially sidelined. Recently, the moratorium on RAC reviews of hospital short stays was extended again until October 2015. This two-year moratorium prevents auditors from looking at the number one area for mis-billed Medicare […]