Controversial Medicare auditors group changes name, website

A Medicare payment watchdog group saddled with huge case backlogs and heavily criticized for causing delays in resolving reimbursement issues has changed its name and location on the web.

The Council for Medicare Integrity, formerly the American Coalition for Healthcare Claims Integrity, will continue to support the recovery audit contractor program and will also work with hospitals and physicians to help lower improper payments, the group said in announcing its new name and website late last week. Its former web address was www.properpayments.org.

Long-term care providers are among the professionals critical of the RAC process. Major provider groups have blamed the RAC program for causing a “tremendous burden on hospitals and the appeals process,” most recently on RAC constituents pushing back on new short-stay provisions. In early February, hospital industry groups said they'd rather the government reform the RAC program than simply throw more money at fixing an onerous backlog of more than 800,000 Medicare appeals cases.

In a Feb. 26 statement, Council for Medicare Integrity spokesperson Kristin Walter said the name change symbolizes the group's evolution “from an exclusive focus on advocacy to reflect new offerings and a partnership with Medicare stakeholders who all share a commitment to fighting waste in this important program.”

RAC contractors audit providers' Medicare claims and earn commissions on improprieties found. In fiscal 2013, the program reportedly identified nearly $3.75 billion in improper payments. The CMI website now claims,  “Medicare loses over $40 billion due to improper payments every year.”

The new website includes provider resources designed to lower improper payments, information on the Medicare appeals process, as well as on how the Centers for Medicare & Medicaid Services administers the Comprehensive Error Rate Testing program, which calculates the improper payment rate for Medicare fee-for-service, according to published reports.