The RAC Prepayment Review demo would allow RACs to review claims before they are paid to ensure the hospital or provider complied with all Medicare payment rules. The reviews will focus on specific types of claims with historically high improper payment rates, such as cardiac and orthopedic procedures, and it will only focus on 11 states with high populations of fraud- and error-prone providers and high claims volumes of short inpatient hospital stays.
Additionally, the prior Authorization of Power Mobility Devices demonstration, which was also postponed, will begin on or after June 1. The Part A to Part B Rebilling demonstration was the only one of the three new initiatives that started this past Jan. 1.
Related Articles on the RAC Prepayment Review Demonstration:
CMS Shelves RAC Prepayment Review Demonstration
Medicare Prepayments for Heart, Orthopedic Procedures Limited to Florida
CMS to Launch Three Demonstration Programs to Curb Improper Payments
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