CMS Delays New RAC Contracts

CMS will postpone awarding new Medicare recovery audit contractor contracts until at least Aug. 15 due to a lawsuit filed by CGI, a current RAC, according to an AHA News report.

CGI filed the lawsuit in federal court objecting to CMS' proposed payment terms for the new RAC contracts, and the agency has agreed to postpone awarding the contracts while the case proceeds, according to the report.

CGI has claimed the payment terms proposed by CMS in the new contracts will create "an intolerable revenue flow model," according to a RAC Monitor report. Currently, RACs can receive their contingency fees following the exhaustion of the first level of appeal of a claim determination. Under the new contracts, RACs can't receive that payment until the second level of appeal is exhausted, according to the report.

More Articles on Medicare RACs:
CMS: 5 Key Measures of Success for Medicare RACs
Rep. Jim McDermott Advocates for More RAC Accountability
CMS Announces 5 Changes to RAC Program, Halts Documentation Requests 

 

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