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Healthcare › Recovery Audit

Perkins Coie

DOJ’s False Claims Act Recoveries Drop to $2.2 Billion in FY 2020—But the Decrease May be Short-Lived

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The U.S. Department of Justice (DOJ) recovered more than $2.2 billion in settlements and judgments from civil cases under the False Claims Act (FCA) in the fiscal year ending September 30, 2020. This is a drop of more than...more

King & Spalding

Annual RAC Report Shows Significant Drop in Recoveries by CMS in 2014

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On October 15, 2015, CMS released its annual recovery auditing report to Congress. CMS’s Recovery Auditor (RAC) program identifies and corrects improper payments through a combination of prepayment and post-payment reviews,...more

Akerman LLP - Health Law Rx

Two-Midnight Rule Update

Akerman LLP - Health Law Rx on

The Centers for Medicare and Medicaid Services (CMS) announced a further delay, through December 31, 2015, of the Recovery Auditors’ (RA) audits of the “Two-Midnight” Rule. Congress previously passed a law delaying...more

K&L Gates LLP

MACRA Brings Modifications to the Recovery Audit Program

K&L Gates LLP on

This is the second K&L Gates Health Care Client Alert discussing the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA), signed into law by President Barack Obama on April 16, 2015. This alert focuses on...more

Williams Mullen

CMS Proposes Rule That Would Expand Its Authority To Audit Medicare Advantage Plans

Williams Mullen on

On April 30, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update payment policies and rates for inpatient hospitals (the “Proposed Rule”) that includes a provision with significant...more

King & Spalding

Recently Released Data Show Current Status and Future of Medicare Integrity Efforts

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Last week, CMS and the Government Accountability Office (GAO) published two reports concerning Medicare contractor developments. In the Medicare Fee for Service National Recovery Audit Program Quarterly Newsletter, CMS...more

Baker Donelson

CMS Issues FAQs for Inpatient "2 Midnight" Rule

Baker Donelson on

CMS issued its first set of FAQs on the new 2 midnight inpatient admission standards [PDF] on September 26. In those FAQs, CMS stated: - Medicare Administrative Contractors (MACs) and Recovery Auditors are not to...more

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