News & Analysis as of

Recovery Audit Hospitals

Parker Poe Adams & Bernstein LLP

As Medicare Audit Season Approaches, an Update on the Appeals Backlog

The federal government recently awarded new contracts for Medicare recovery audits, and recovery audit contractors (“RACs”) will start showing up at hospitals, home health providers, and other facilities any time. But this...more

King & Spalding

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

King & Spalding on

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

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

King & Spalding

MedPAC Releases June 2015 Report to the Congress

King & Spalding on

The Medicare Payment Advisory Commission (MedPAC) released its “Report to the Congress: Medicare and the Health Care Delivery System” on June 15, 2015. As previously reported, the report makes recommendations for policy...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

Faegre Drinker Biddle & Reath LLP

AHA Renews Complaints about OIG Hospital Compliance Reviews

The American Hospital Association (AHA) has renewed its complaints about OIG “hospital compliance reviews.” Last Thursday AHA Executive Vice President Rick Pollack sent a letter to Health & Human Services Secretary Burwell...more

Faegre Drinker Biddle & Reath LLP

Who Audits the Auditors?

Since the advent of Medicare in 1965, hospitals have bemoaned the cost and burden of Medicare audits. The complaints increased when CMS hired private contractors for the audits. They became deafening in 2009 with the advent...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

The Volkov Law Group

Hospitals And Fraud Enforcement

The Volkov Law Group on

The HHS Office of Inspector General has targeted hospitals for fraud enforcement. It is one of the OIG’s most important initiatives because of the impact it could have on reducing health care costs....more

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