All Entries Tagged With: "RAC"

Have a RAC question? CMS has some answers

Although none of the newest Recovery Audit Contractor FAQs released by CMS—it published 15 in the last two weeks—is particularly surprising, they are perhaps a sign that CMS is continuing to make every effort to share RAC information providers need to know, through as many channels as possible.

It may be sharing the same information during RAC outreach sessions or during Open Door Forum calls, but now the information is also readily available to those who wish to learn about RACs in a Q&A format.

Read the full report by Andrea Kraynak for HealthLeaders Media.

CMS updates RAC audit timeline: complex reviews still months away

CMS anticipates Recovery Audit Contractor (RAC) automated reviews will begin in late June and July, according to Marie Casey, deputy director of the Division of Recovery Audit Operations at CMS. However, this is not set in stone, she says, noting, "there is some leeway."

But complex reviews won't begin until later, says Casey. CMS is aiming to begin certain types of complex reviews (e.g., coding and DRG validation) this fall. However, medical necessity complex reviews won't begin until early 2010.

The nature of automated reviews is simpler on the whole, she says, making them an easier choice to roll out first. "The automated reviews are less burdensome on the provider, because there's no request for medical records," says Casey, adding that automated reviews are also easier on the RACs themselves to manage.

Read the full story by Andrea Kraynak of HealthLeaders Media.

NEWS: Six of 10 RACs in New York overturned on appeal

Nearly 60% of Medicare’s Recovery Audit Contractor (RAC) determinations in New York State were given back to facilities after appeals, the Healthcare Association of New York reports.

About 33% of providers appealing RAC determinations won their cases and recouped their money.

To read the full story by the Healthcare Association of New York, click here.