American Hospital Association Releases New RACTrac Results

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Hospital providers continue to report increases in RAC activity, according to the results of the American Hospital Association’s (AHA) most recent RACTrac survey, which reports survey results from the second quarter of 2013.  The AHA launched RACTrac in 2009 to track and summarize the impact of RAC activities on hospitals nationwide in response to the lack of data provided by CMS. 

According to the AHA’s recently released survey results:

  • Medical record requests have increased by 47% and the number of complex audit denials has increased by 58% since the fourth quarter of 2012;
  • According to the RAC, 60% of medical records reviewed did not contain an overpayment;
  • Medical necessity denials were the most costly denials according to 67% of hospitals;
  • Of the short-stay denials for medical necessity, 62% were because the care was provided in the wrong setting, not because the care was medically unnecessary;
  • Hospitals appealed 40% of all RAC denials with a 70% success rate in the appeals process; and
  • 45% of hospitals reported having a RAC denial reversed by utilizing the discussion period.

The AHA invites hospital representatives to attend a free webinar on September 19, 2013 that will cover recent CMS regulations impacting the RAC program and the recent RACTrac survey results.  Please click here to access a copy of the RACTrac survey and for more information regarding the September 19 webinar. 

Reporter, Kerrie S. Howze, Atlanta, +1 404 572 3594, khowze@kslaw.com.

Topics:  American Hospital Association, Hospitals, RACTRAC

Published In: Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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