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Open Letter to Congress: Reform the RAC Appeals Process, Preserve Medicare’s Top Integrity Program

  The American Coalition for Healthcare Claims Integrity today sent the following letter to members of the House and Senate who have cosponsored The Medicare Audit Improvement Act of 2013 (H.R. 1250 and S. 1012) – legislation that effectively shuts down the highly successful Recovery Audit Contractor (RAC) Program.  Jan. 21, 2014 The Honorable Sam Graves U.S. House of Representatives Dear Rep. Graves: The nation is currently facing the systemic dismantling of healthcare integrity programs that fight an epidemic of […]

Becker’s Hospital Review: Coalition Asks HHS to Reform Medicare RAC Appeals Process

  Following the recent suspension of a large portion of Medicare appeals reviews, our coalition is urging lawmakers to rectify the appeals process for the sake of providers, beneficiaries and the Medicare Trust Fund. FROM BECKER’S HOSPITAL REVIEW: The nonprofit American Coalition for Healthcare Claims Integrity has called on HHS to reform the appeals process for payment denials from Medicare recovery audit contractors. The coalition issued its statement, which was included in letters to House and Senate members, in response to the […]

Wall Street Journal: Government Pulls in Reins On Disability Judges

  Earlier this week, the Social Security Administration announced it is cracking down on administrative law judges (ALJ), which have become a source of waste and abuse of disability benefits. According to officials, the ALJ has lacked proper parameters for granting disability benefits, leading to rapid depletion of the Social Security trust fund. Recovery Auditors have called for similar reforms of the ALJ and the Recovery Audit Contractor (RAC) Program appeals process, due to their inconsistency in deciding cases and […]

CAGW President Tom Schatz Testifies on Government Waste

  Today,  Tom Schatz, President of Citizens Against Government Waste (CAGW) testified before the House Committee on Oversight and Government Reform on ways to reduce wasteful government spending. In his comments, Schatz listed Medicare improper payments as a high-priority area of government waste, and urged lawmakers to bolster healthcare integrity initiatives like the Recovery Audit Contractor (RAC) program.  FROM CAGW.ORG: Citizens Against Government Waste (CAGW) President Tom Schatz testified today before the House Committee on Oversight and Government Reform. Committee […]

Medicare Integrity Coalition Applauds Chairman Issa For Considering Ways to Strengthen the RAC Program

  FOR IMMEDIATE RELEASE January 9, 2014 CONTACT:  Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Medicare Integrity Coalition Applauds Chairman Issa For Considering Ways to Strengthen the RAC Program ACHCI echoes calls to preserve the highly effective RAC program, delivers 2013 ‘to-do list’ to Congress  Washington, D.C. – Today, Thomas Schatz, president of the Council for Citizens Against Government Waste (CAGW) testified before the House Committee on Oversight and Government Reform, headed by Chairman Darrell Issa (R-CA), on ways to eliminate wasteful […]

CCAGW Opposes Bill to Delay Two-Midnight Rule Enforcement

  Today, the Council for Citizens Against Government Waste (CCAGW) voiced its strong opposition to H.R. 3698, the Two-Midnight Rule Delay Act of 2013, introduced by Rep. Jim Gerlach (R-Pa.) on December 11, 2013.  The legislation delays enforcement of Medicare’s two-midnight rule for reimbursement of short inpatient hospital admissions from March 31, 2014 to October 2014. The bill is a direct assault on the most successful Medicare oversight tool taxpayers have ever had: recovery auditing contractors (RAC), which have clawed back $4.8 […]

CMS Report: Providers Falsely Billed Medicare by $49.9 Billion in 2013

  FOR IMMEDIATE RELEASE December 19, 2013                                                                 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 CMS Report: Providers Falsely Billed Medicare by $49.9 Billion in 2013 Report shows uptick in improper payments, calls for increased program oversight and auditing Washington, D.C. – The American Coalition for Healthcare Claims Integrity (ACHCI) today released […]

Congressional Budget Office Warns Congress of $2 Billion Impact of Extending RAC Program Moratorium

  FOR IMMEDIATE RELEASE December 12, 2013                                                                 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Congressional Budget Office Warns Congress of $2 Billion Impact of Extending RAC Program Moratorium Office says further delays to RAC program not an option;Lawmakers remove proposal in Sustainable Growth Rate patch Washington, D.C. – The American Coalition for […]

CMS Reports High Accuracy of RAC Audits

  FOR IMMEDIATE RELEASE December 5, 2013                                                                 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 CMS Reports High Accuracy of RAC Audits  Finds average 95% accuracy rate across all auditors Washington, DC – A report from the Centers for Medicare and Medicaid Services (CMS) to Congress entitled, Recovery Auditing in the […]

OIG: Recovering Misused Funds is Top Priority in 2014

  The U.S. Department of Health and Human Services Office of Inspector General released its four-year strategic plan this week. From 2014-2018, the agency plans to bolster its effort to combat healthcare waste, fraud and abuse, and to strengthen its focus on recovering improper payments from providers. FROM OIG: Critical to OIG’s mission is fighting fraud, waste, and abuse. We will continue to employ a multi-faceted approach of prevention, detection, and deterrence. Priority: Identify, investigate, and take action when needed […]