RAC transition: Fewer document requests but no slowing of therapy reviews, CMS says

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Report: Long-term care providers pay the price for CMS' poor auditor oversight
Report: Long-term care providers pay the price for CMS' poor auditor oversight

Providers will see fewer Additional Document Requests starting in June, as the Centers for Medicare & Medicaid Services transitions to new Recovery Audit Program contracts. CMS has started the contract procurement process by issuing a request for quotes through the General Services Administration, according to a Medicare newsletter released Thursday.

CMS is seeking four A/B Recovery Auditors, one national Durable Medical Equipment auditor and one Home Health/Hospice Recovery Auditor.

Although ADR requests will decrease, CMS does not plan to slow down other aspects of the auditing program. Details will be forthcoming on the RAC website, according to CMS. Prepayment reviews and post-payment manual therapy reviews will “continue without decline,” the agency said.

Long-term care providers and advocates, including the National Association for the Support of Long-Term Care and the American Health Care Association, have expressed concern over the RAC manual therapy reviews that began last month. It was a “disappointment” that a recent CMS memo on therapy caps did not address this issue, NASL Executive Vice President Cynthia Morton told McKnight's. AHCA President and CEO Mark Parkinson described the new review process as “confusing and wholly inappropriate” in a letter to CMS Acting Administrator Marilyn Tavenner.

AHCA has launched a clearinghouse to gather provider feedback about the new system.