CMS Announces New Limits on RAC Requests for Medical Records

CMS has set new limits on the number of medical records that recovery audit contractors may request, according to a release from CMS.

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1. New 1 percent limit on all claims submitted for the previous calendar year, divided into eight periods of 45 days each.

2. New cap of 300 additional documentation requests per each 45-day period for providers that bill more than 100,000 Medicare claims, running from April through Sept. 2010.

3. New provision allowing RACs to request permission to exceed the cap in fiscal year 2010.

4. New definition of a hospital campus qualifying for the limits, based on the organization’s tax identification number and ZIP code information.

Read the CMS’ release on recovery audit contractors (pdf).

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