CMS has announced a demonstration project that will allow RACs to conduct prepayment review of claims in 11 states. Aside from the fact that RACs will review claims prior to payment, the review process will be identical to the post payment process currently employed by RACs. The affected states include seven states, Florida, California, Michigan, Texas, New York, Louisiana, and Illinois, which were selected on the basis of population and error rates for claims. The four remaining states, Pennsylvania, Ohio, North Carolina, and Missouri were selected based on the states’ high claims volume for short inpatient stays...
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