Category Archives: RAC

09 Jan

Medicare delays RAC demonstration program intended to hold back payments to hospitals

CMS has announced that it will postpone its Recovery Audit (RAC) Prepayment Review demonstration project that would have held up payments to hospitals until the Medicare RAC reviews the claim to ensure that the provider complied with all Medicare payment rules. The Medicare RAC Prepayment Review demonstration called for the RACs to conduct prepayment review of claims for 15 procedures that historically result in high rates of improper payments. Many doctors were unhappy with the proposed program, especially cardiologists, who would be most affected since 11 of the 15 procedures identified for Medicare RAC prepayment review affect cardiologists.

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25 Oct

RAC expands to State Medicaid Program

Through an Oct. 1 letter to State Medicaid Directors, Peter Budetti, Deputy Administrator for the Center for Medicare and Medicaid Services (CMS), provided initial guidance on the implementation of the  Recovery Audit Contractor (RAC) programs by State Medicaid agencies. Section 6411 of the Affordable Care Act, calls for the expansion of the RAC Program by

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