For recovery auditing professionals everywhere, performance-based payments are a financial best practice and the industry standard. The client wins when no upfront expenses occur and payments are made...
Watchdog: CMS should monitor Recovery Audit Data warehouse
By
John Hall
Apr 17, 2015
A new Government Accountability Office report recommends sweeping government reforms that would mitigate fragmentation and duplication of a number of Medicare and Medicaid programs.
Ask the payment expert … about RACs
Apr 06, 2015
I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?
Judge blocks award of new RAC contracts
By
James M. Berklan
Oct 01, 2014
Medicare’s Recovery Audit Contractor program continues to struggle with controversy.
CMS should publicly push Congress to reform therapy payment system, long-term care provider association...
By
Tim Mullaney
Sep 09, 2014
The Centers for Medicare & Medicaid Services should openly urge Congress to change the way therapy services are reimbursed, the nation’s largest long-term care provider association stated in recent...
Federal judge blocks new RAC contracts
By
Tim Mullaney
Sep 04, 2014
Adding to the ongoing controversy around Medicare’s Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.
OIG revenues off $1 billion as oversight relaxes
By
John Hall
May 28, 2014
Revenues from Department of Health and Human Services Office of Inspector General audits and investigations for the the first half of fiscal 2014 are expected to drop almost $1 billion from the same period...
McDermott urges RAC penalties for successfully appealed decisions
By
Tim Mullaney
Mar 21, 2014
Medicare recovery audit contractors should face financial penalties when providers successfully challenge their decisions, Rep. Jim McDermott (D-WA) stated in a recent letter to the head of the Health...
Long-term care groups applaud a pause in Medicare audits, urge permanent changes
By
Tim Mullaney
Feb 21, 2014
Long-term care stakeholders are praising the government’s decision to temporarily pause the recovery audit contractor program, which is associated with a huge backlog of Medicare claims appeals.
RAC program needs better oversight, Inspector General report finds
By
Tim Mullaney
Sep 05, 2013
Recovery audit contractors might be better at reviewing Medicare claims than critics allege, but the Centers for Medicare & Medicaid Services could improve RAC performance evaluations, according to a new...