Hospital CMO: Fighting RACs "Not a Level Playing Field"

At an executive briefing hosted by the American Hospital Association yesterday, four health system leaders described their challenges in dealing with undue denials by Medicare Recovery Auditors, formerly known as recovery audit contractors.

Steven Hanks, MD, executive vice president and chief medical officer of The Hospital of Central Connecticut in New Britain, said RACs have denied payment for inpatient services billed under Part A that the RACs say should have been performed in outpatient settings. His hospital has appealed 96 percent of denials and won 94 percent of those appeals.

"RACs have nothing to do with fraud and abuse," Dr. Hanks said, according to an AHA release. "It's not a level playing field when RACs are paid on commission to indiscriminately deny claims."

More Articles on Medicare RACs:

Almost All Hospitals Receive Medicare Pay Adjustments, GAO Says
Medicare RAC Overpayment Collections Hit $4.5B Since 2009
HHS Proposes $9.9M Reward for Reporting Medicare Fraud

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