Medicare RAC audit cuts a 'serious concern,' senator says

Recent cuts to the number of documents a recovery audit contractor can request from a provider is “troubling,” Senate Finance Committee Chairman Orrin Hatch (R-UT) said in a letter to the Centers for Medicare & Medicaid Services.

In the Nov. 12 letter, Hatch cited his “serious concerns” about the rate reduction, which would decrease the annual additional document request limit from 2% of all paid claims to 0.5%. The lower record limit would “significantly curtail the ability of the [RACs] to operate as Congress intended them to,” Hatch wrote.

Hatch noted that while he understood some RAC policies were changed in response to the two-midnight rule, he believes CMS needs to strengthen its oversight in the Medicare program.

“It is both astonishing and unacceptable that one in every 10 dollars spent on the Medicare program is spent improperly,” Hatch wrote.

The chairman did point to a report released by CMS last month that showed RACs identified more than 1.1 million improper Medicare claims worth $2.57 billion in fiscal year 2014, saying that the recovery levels were “appreciated,” but “are just a drop in the bucket compared to the waste, fraud and abuse identified by the Government Accountability Office.”