Medicare RACs, Hospitals Spar Over New Fraud Legislation

A bipartisan bill that would reform Medicare Recovery Auditors, or Medicare RACs, has enflamed a battle between hospitals that support it and the RACs that oppose it, according to a report from The Hill.

Last month, House Reps. Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) reintroduced the Medicare Audit Improvement Act. Under this bill, Medicare RAC record requests would be capped to 2 percent of hospital claims, with a maximum of 500 medical record requests every 45 days, among other measures.

The American Coalition for Healthcare Claims Integrity, a non-profit RAC supporter group, argued the bill would result in billions of taxpayer dollars in improper hospital payments. "The bottom line is that recovery auditors bring accountability and transparency to the Medicare program," ACHCI spokesperson Amanda Keating told The Hill. "If you want to send Medicare crashing to the ground, letting improper payments run rampant is a surefire way to do that."

The American Hospital Association, however, has long lobbied for a more "streamlined" solution to Medicare payment oversight, such as the proposed bill. "It's understandable that the government wants to make sure they're getting what they've paid for, but hospitals are having a very difficult time," Michael Ward, senior associate director of policy with the AHA, said in the report. "It can take them two to three years to receive a final determination on a claim."

More Articles on Hospitals and Medicare RACs:

House Reintroduces Bill to Reform Medicare RACs
CMS Proposes Changes to Medicare Part B Billing for Hospitals
CMS: Medicare RACs Take Back $745M in Overpayments in 1Q of 2013

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