Watchdog urges Medicaid to bolster overpayment collection efforts
By
Kimberly Marselas
Jun 30, 2023
The Government Accountability Office is urging Medicaid overseers to do a better job of recouping overpayments, citing their allegedly lenient oversight of state auditing efforts.
Amid dire economic reports, wasteful Medicare spending must stop
By
Kristin Walter
Jun 25, 2018
Given the significant financial pressures facing our federal government and with the health and economic security of nearly 48 million American seniors on the line, Congress must act now to authorize CMS...
Congress should require more Medicare claim auditing — before and after payment
By
Kristin Walter
Mar 16, 2018
There is a much more efficient solution to reducing Medicare spending than the proposed broad cuts to the program budget: Reduce the billions of dollars in incorrect payments each year.
Lawmakers go to bat for providers over backlogged Medicare appeals
By
James M. Berklan
May 22, 2014
Angry lawmakers ripped an overwhelmed Medicare appeals process that has wilted under a tenfold increase in audits recently. Federal officials from two key agencies agreed that the Medicare’s Recovery...
Ask the payment expert … about RAC nursing home audits
By
Patricia Boyer
Aug 01, 2013
We keep hearing about RACs in skilled nursing homes but we haven’t seen any in our state, so why should we worry about them?
Senators see flaws in RAC payment system
By
Elizabeth Newman
Aug 01, 2013
Aspects of the Medicare Recovery Audit Contractor program came under intense scrutiny during a Senate Finance Committee hearing in June. Lawmakers questioned auditor payment incentives and a sluggish appeals...
Power to the people? That could mean trouble
By
James M. Berklan
Apr 01, 2013
There are plenty of legal concerns that keep nursing home administrators awake at night. Many times, the demons can be kept under the bed or locked in the closet. But not always.
Shamelessly invoice at your own risk
By
John O'Connor
Mar 22, 2013
Here’s the good news for providers: new analytics are making it possible to understand and bill your care in ways that would have been impossible just a few years ago. Here’s the bad news:...
RAC audits: Skilled nursing facilities accounted for miniscule portion of 2011 Medicare overpayments
By
McKnight's Staff
Feb 07, 2013
Skilled nursing facilities accounted for only about $200,000 of $797 million in collected Medicare overpayments in 2011 identified by Recovery Audit Contractors, according to an annual audit report released...
Providers urge federal investigation into inaccuracy of RAC audits
By
McKnight's Staff
Oct 26, 2012
A major hospital group has called for a federal investigation into mistakes made by recovery audit contractors. “Numerous inaccuracies” often result in improperly denied payments and decisions...