Although RACs have always had the power to extrapolate overpayments, they will be actively encouraged to do so within the coming year. RACs extrapolate overpayments made to a facility by projecting a global error rate to a universe of claims using a sampling of a specific set of statistics. Extrapolation will likely be focused on small dollar claims identified in the Comprehensive Error Rate Testing program, which may require providers to reevaluate their defense strategies, according to the report.
CMS made other predictions for the coming year at the conference, including an increase in RAC involvement in appeals, especially at the administrative law judge level. CMS also described an effort to use the term “recovery auditor” instead of RAC.
Read the Lexology report on recovery audit contractors.
Read more coverage on RACs:
– Physicians Doing Work of RACs, Study Seems to Indicate
– CMS Clarifies Remittance Advice
– RACs’ Semi-Automated Review Explained
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
