Ever face the choice between trading in your old car or paying for multiple repairs?  CMS faced that kind of choice with its Recovery Audit Contractor (RAC) program.  Under the RAC program, contract auditors audit hospitals and other providers.  Guess how they’re paid?  They get a percentage of all the money they recover.  To the provider community, that’s like having private contractors hand out traffic tickets and then get a cut of each fine.

So the complaints to CMS have been nonstop.  And the rate of RAC decisions being overturned is sky high.  But perhaps worst of all is the appeal backlog.  At last count, it stood at a mountainous 800,000.

But back to the Hobson’s choice.  CMS decided to repair the program rather than trade it in. Starting December 30, new audit contracts will reflect changes to address what CMS sees as the top 20 greatest “provider concerns.”

One of the more welcome changes limits the audit look-back period to six months from the date of service instead of the current three years.

Providers will still hate the RAC program, but maybe with slightly less intensity.