In February, CMS said the demonstration would move forward “on or after June 1, 2012.” CMS also delayed the demonstration from Jan. 1, 2012 — the original date.
The RAC Prepayment Review would allow RACs to review claims before they are paid to ensure the hospital or provider complied with all Medicare payment rules. The reviews will focus on specific types of claims with historically high improper payment rates, such as cardiac and orthopedic procedures, and it will only focus on 11 states with high populations of fraud- and error-prone providers and high-volume claims for short inpatient hospital stays.
The 11 states included in the RAC demo are Florida, California, Michigan, Texas, New York, Louisiana, Illinois, Pennsylvania, Ohio, North Carolina and Missouri.
CMS also said it will hold an open door forum in August to discuss the demonstration and details.
More Articles on the RAC Prepayment Review Demonstration:
RACs Hold Payments Up-Front Starting June 1, 2012: Understanding the New RAC Pre-Payment Reviews
RAC Prepayment Review Demo to Begin June 1
CMS to Launch Three Demonstration Programs to Curb Improper Payments
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