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Inside Health Policy: RACs Ask To Be More Involved In ALJ Appeals

  Recovery Audit contractors want to be more involved at the ALJ appeal level to help speed up the process and cut back the growing backlog of appeals. FROM INSIDE HEALTH POLICY: Recovery Audit contractors say they should be more involved in the Medicare appeals process, and they say those involved with appeals should be notified about hearings. The Office of Medicare Hearings and Appeals recently requested suggestions for reducing the backlog of appeals at the Administrative Law Judge level […]

Wall Street Journal: New Medicare Rules Aim to Reduce Abuse

  The Obama administration has enabled the Centers for Medicare and Medicaid Services to take direct action to kick doctors out of the Medicare program for abusive billing practices. FROM THE WALL STREET JOURNAL: The Obama administration on Wednesday strengthened Medicare’s authority to kick doctors and other medical providers out of the federal program for abusively billing the government. The move represents a significant shift in how the government tackles waste in Medicare, the insurance program for the elderly and […]

American Action Forum Release RAC Program Primer

  The American Action Forum, a Washington-based policy institute, released a primer today that provides a valuable introduction to the Recovery Audit program, the “Two-Midnight” rule, and the issues surrounding Medicare integrity. Read the primer on the here, at the AAF website.

Medicare FFS Error Rate Continues To Increase In Fiscal 2014

  As the RAC moratorium continues, the Medicare fee-for-service error rate has climbed to the highest rate in history. Read more from Inside Health Policy: FROM INSIDE HEALTH POLICY: The Medicare fee-for-service improper payment rate rose again in fiscal 2014, to almost 13 percent, according to a report recently released by HHS, and Recovery Audit Contractors point out that the increase coincides with CMS’ decision to pause the RACs and limit what audits they could conduct. The HHS FY 2014 […]

Medicare Improper Payment Rate Continues To Climb, Recoveries Decline As RACs Are Sidelined

FOR IMMEDIATE RELEASE November 24, 2014 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Medicare Improper Payment Rate Continues To Climb, Recoveries Decline As RACs Are Sidelined The FY2014 Medicare FFS program improper payment rate is now 12.7%, representing a $46.0 billion annual loss to the program Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) have released the Medicare fee-for-service Recovery Audit Program’s annual report to Congress for the fiscal year 2013. The report shares that during that year Recovery Audit […]

Bloomberg BNA: Rep. Brady Releases Draft Bill to Alter Medicare Hospital Payment Policies

  Rep. Kevin Brady (R-TX) released a discussion draft of his bill to alter Medicare payment policies. Bloomberg BNA outlined the legislation and stakeholder response in a Nov. 20 article: FROM BLOOMBERG BNA: Nov. 20 — House Ways and Means Health Subcommittee Chairman Kevin Brady (R-Texas) Nov. 19 released a discussion draft of a bill that would change how Medicare pays for some hospital stays. The draft bill, titled the Hospital Improvements for Payment (HIP) Act of 2014, would address […]

The Hill: RACs rock, so stop gutting the program

  The RAC program is “the most successful tool for Medicare program integrity that taxpayers have ever had”. Let’s keep it that way. FROM THE HILL: On Sept. 29, the Centers for Medicare and Medicaid Services (CMS) released its annual report to Congress on the Recovery Auditing Contractor Program (RACs). The RACs scour Medicare fee-for-service claims for improper payments, examining about 2 percent of the more than 1 billion annual Medicare claims since the RAC program went nationwide in 2009. RACs have […]

Healthcare Dive: The Friday Dive: Industry reactions to RAC figures mixed

  The Fiscal Year 2013 CMS report to Congress finds that Recovery Audit Contractors returned over $3 billion to the Medicare Trust Fund in 2013. FROM HEALTHCARE DIVE: “At 10.1%, the Medicare fee-for-service error rate is the highest of all federal programs,” Kristin Walter, spokesperson for The American Coalition for Healthcare Claims Integrity. “Our coalition urges lawmakers to support the RAC program and the important role it plays in maintaining a stronger, more efficient Medicare program for the millions of retirees and […]

FY2013 RAC Report To Congress: RACs are Effective, Accurate And Rarely Overturned on Appeal

FOR IMMEDIATE RELEASE September 29, 2014 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 FY2013 RAC Report To Congress: RACs are Effective, Accurate And Rarely Overturned on Appeal Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) have released the Medicare fee-for-service Recovery Audit Program’s annual report to Congress for the fiscal year 2013. The report shares that during that year Recovery Audit Contractors (RACs) recovered more than $3 billion in Medicare overpayments to providers; have an average accuracy score […]

McKnights: RACs Return $100 Million to Providers, as Criticism Grows

  Between April and June 2014, RACs returned $100 million to providers, the program’s most outspoken critics. FROM McKNIGHTS: Medicare Recovery Audit Contractors returned a record $100.4 million in identified underpayments to providers between April and June. Figures released by the Centers for Medicare & Medicaid Services also show a 22% drop in overpayments returned from providers to the Medicare Trust Fund in the third quarter. That’s likely due to a pause in RAC activity pending a new round of […]