The hearing, titled “Improving Audits: How We Can Strengthen the Medicare Program for Future Generations,” will take place Wednesday afternoon. CMS’ recovery audit contractor program — which started in 2009 and involved independent contractors — aims to ensure all Medicare and Medicaid payments are proper. Medicare RACs have performed a vast majority of the audits in the first four-plus years, recouping almost $2.25 billion in Medicare funds from hospitals and other providers from July through December 2013 alone.
The American Hospital Association has urged CMS to improve the RAC program by adopting the reforms included in the Medicare Audit Improvement Act of 2013, under which Medicare RACs would be limited to a hard cap of additional medical record requests. The bill would also impose financial penalties on RACs for auditing errors, improve RAC transparency and allow denied inpatient claims to be billed as outpatient claims when appropriate. Additionally, the AHA has expressed concern about a temporary suspension in administrative law judge hearings concerning payment denials from RACs.
More Articles on RACs:
CMS: 5 Key Measures of Success for Medicare RACs
Rep. Jim McDermott Advocates for More RAC Accountability
Audit Focus 2014: New Boundaries, Rules Changing the Audit Landscape
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