RAC Actions Against Physician Practices Becoming More Noticeable

Actions by recovery audit contractors against physicians, still a small part of overall RAC actions, have become more noticeable in recent months, according to a report by the American Medical News.



The Medical Group Management Association reports that more members have been receiving automated audit notices from RACs during the past six months. The alleged errors involve such matters as payment for office-based administration of drugs and services for new patients.


Two out of eight common compliance issues identified in an April RAC report by CMS applied to physician billing. For example, CMS cited untimed codes to bill for outpatient rehabilitation therapy services.


Practices complain that the time and hassle for complying with RACs' documentation requests can exceed the potential dollar amount of the payment under dispute. "The American Medical Association continues to have concerns about the perverse incentive structure and burdensome nature of the Medicare recovery audit contractor program and firmly believe that the best way to reduce improper coding is through education and outreach," said AMA President Cecil B. Wilson, MD.


Read the American Medical News report on recovery audit contractors.


Related Articles on RACs and Physicians:

9 RAC Audit Targets Involving Surgeons

Physicians Doing Work of RACs, Study Seems to Indicate

Medicare Carrier Finds 50-90% Error Rate for E/M Codes


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