AHA: Medicare RAC Reviews on the Rise for Hospitals

Nine out of 10 hospitals participating in the American Hospital Association's RacTrac survey experienced Medicare recovery auditor, or RAC, activity in the third quarter of 2013, consistent with second quarter findings.

The AHA collected data from 2,452 hospitals, of which 2,164 reported RAC activity through September 2013 as part of the survey, which the group conducts quarterly to assess how Medicare RACs affect hospitals. AHA created the web-based survey because of the lack of data from CMS concerning the impact RACs have on providers, according to the RACTrac website.

Here are some key findings from the third quarter results:

1. Cumulative medical record requests have increased by 13 percent since the first quarter of 2013, and cumulative complex audit denials reported by respondents went up by 28 percent during the same six-month period.

2. Of the medical records RACs reviewed through the third quarter, 56 percent didn't contain an improper payment.

3. Hospitals reported $2.5 billion in denials through the third quarter, according to the survey.

4. Sixty-eight percent of hospitals reported spending more than $10,000 managing the RAC process during the third quarter.

More Articles on Medicare RACs:
Citizen Group Opposes Temporary Medicare Audit Suspension
OIG: First-Level Medicare Appeals Up 33% From 2008 to 2012
AHA Asks Hospitals to Participate in Medicare RAC Survey 

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