Medical Necessity Reviews Underway by Region D RAC

The Recovery Audit Contractor for Region D has begun medical necessity reviews for 10 types of inpatient hospital conditions, according to a report by AHA News Now.

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HealthDataInsights, the RAC for Region D, covers Alaska, Arizona, California, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming,

On Aug. 6, CMS approved medical necessity review audits for 18 inpatient conditions. RACs can begin auditing these conditions after posting the audits on their websites. To date, only the RACs for Region D and Region B have posted audits related to medical necessity reviews. Region B’s RAC, CGI Technologies and Solutions, has begun audits on six of the inpatient conditions.

Read the AHA News Now report on RAC medical necessity reviews.

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