Loophole allows low volume Medicare providers exemption from auditing
By
Kristin Walter
Dec 15, 2017
The current implementation of Medicare’s sliding scale ADR limit policy is preventing the recovery of improper payments and has afforded a significant portion of providers with immunity from billing...
Why is it so easy to ignore Medicare improper payments?
By
Kristin Walter
Oct 28, 2015
Recovery auditors corrected more than $2.57 billion in improper payments for FY 2014 – representing 5% of the $46 billion in wasted taxpayer dollars the program lost in a comparable period to fraud,...
Providers suffering Medicare appeals backlog — at their own hand?
By
James M. Berklan
Apr 29, 2015
If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn’t be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise,...
RAC battles move forward
By
Amy Novotney
Apr 06, 2015
The debate over whether Recovery Audit Contractor audits are an incentive-laced system of provider harassment or a necessary tool to redistribute misspent Medicare funds continues. Neither side appears...
Medicare payment group changes name
By
John O'Connor
Apr 06, 2015
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.
What’s in a name?
By
Tara Roberts
Mar 04, 2015
The new name of the American Coalition for Healthcare Claims Integrity is the Council for Medicare Integrity. Does that mean they’ll change their focus? Not quite.
Provider groups push for RAC reform
By
John Hall
Feb 06, 2015
Hospital industry groups said Thursday they’d rather the government reform the Recovery Audit Contractor program than simply throw more money at fixing an onerous backlog of more than 800,000 Medicare...
CMS awards Recovery Audit DME contract
Jan 06, 2015
The Centers for Medicare & Medicaid Services has given a recovery audit contract to Connolly LLC, a subsidiary of Connolly iHealth Technologies, in Region 5. The firm will oversee Medicare claims for Durable...
Fuzzy math in RAC audits
By
Tara Roberts
Dec 15, 2014
If you are like me and have children who are required to contribute to science fairs, then you understand that the method in a science project is as important as the topic .It is difficult to explain to...
RACs recoil against bills
By
James M. Berklan
Jul 01, 2013
Independent Medicare auditors are criticizing two measures that would put stricter controls on Recovery Audit Contractors.