CMS said RACs could request up to 500 medical records over a 45-day period from hospitals with more than $100 million in Medicare payments per year, compared with a limit of 300 that still stands for other hospitals. To calculate the threshold, CMS subtracts payments for outliers, DSH, and direct and indirect GME payments from total DRG payments.
In a recent letter to 87 hospitals subject to the new cap, CMS said the high-volume hospitals “have the capability to address a larger number of additional documentation requests.”
Read the AHA News Now report on RACs.
Read more coverage of limits on RAC records requests.
– RACs Now Allowed More Requests to High-Volume Hospitals
– RACs Can Request Claims Not on Approved List
– CMS Announces New Limits on RAC Requests for Medical Records
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