A Command Performant(s): RAC Audits on the Rise
On February 9, 2016 the Obama administration released its proposed fiscal year (FY) 2017 budget. The budget, which would top $4 trillion, allocates nearly $1 trillion to CMS. This is an increase of $26 billion from the FY...more
What to Expect from Congress this Work Period - The next Hill work period basically runs from February 22nd to March 23rd. As Congress returns, here’s a brief look at the pending health care issues on the radar for this...more
While providers would certainly feel the pinch from the FY 2017 budget request submitted by President Barack Obama, hospitals have some new hope on receiving funds tied up in the Recovery Audit Contractor (RAC) appeals...more
The federal government will soon kick off the all-important annual sub-regulatory cycle for the Medicare Advantage (MA) and Part D programs, issuing proposed policy changes and payment rates for calendar year (CY) 2017. The...more
On December 22, 2015, the Centers for Medicare & Medicaid Services (CMS) released a request for information (RFI) and a proposed statement of work (SOW) seeking industry feedback on the expansion of the recovery audit...more
By now, providers are very familiar with Medicare recovery audit contractors, or RACs – the private companies who have authority to review medical records at a moment’s notice. For every dollar they opine has been improperly...more
On December 22, 2015, CMS issued a Request for Information (RFI) detailing plans to expand its Recovery Audit Contractor (RAC) program to cover Medicare Advantage organizations. ...more
During the holiday season lull, the Centers for Medicare and Medicaid Services (CMS) issued a weighty document. The agency put out a draft statement of work to procure Recovery Audit Contractors (RACs) for the Medicare...more
GAO Finds CMS Should Fully Develop Plans for Medicare Advantage Encounter Data and Assess Data Quality Before Use – In a report released on September 2, 2014, GAO evaluated CMS’s plans for using Medicare Advantage (MA)...more