RAC

Controversial Medicare auditors group changes name, website

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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.

RAC audit abuse answers vary

RAC audit abuse answers vary

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It has been more than 2,400 years since Plato demanded to know who will watch the watchmen. The question is suddenly taking on a modern flavor, as nursing homes, hospitals, doctors and other providers line up to decry the practices of Recovery Audit Contractors.

Judge blocks award of new RAC contracts

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Medicare's Recovery Audit Contractor program continues to struggle with controversy.

Federal judge blocks new RAC contracts

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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.

Audits paused, providers glad

Audits paused, providers glad

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Long-term care providers are applauding a pause in the Medicare recovery audit contractor program.

McDermott urges RAC penalties for successfully appealed decisions

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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 and Human Services Department.

RAC program needs better oversight, Inspector General report finds

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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 government report.

Senators see flaws in RAC payment system

Senators see flaws in RAC payment system

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Aspects of the Medicare Recovery Audit Contractor program came under intense scrutiny during a Senate Finance Committee hearing in June. Lawmakers questioned auditor payment incentives and a sluggish appeals process.

RAC audits: Skilled nursing facilities accounted for miniscule portion of 2011 Medicare overpayments

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Skilled nursing facilities accounted for only about $200,000 of $797 million in collected Medicare overpayments in 2011 identified by Recovery Audit Contractors, according to an annual audit report released Tuesday.

New bill would limit power of Medicare recovery audit contractors

New bill would limit power of Medicare recovery audit contractors

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Legislation introduced Tuesday aims to reduce some of the authority Medicare's recovery audit contractors (RACs) wield over investigations into provider claims.

Providers should prepare to face even more audits under healthcare reform, expert warns

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Providers need to have the appropriate staff and data analytics programs in place to defend against the onslaught of more Medicare and Medicaid claims audits, an expert urged.

Providers cannot appeal RAC efforts to re-open payment decisions, court says

Providers cannot appeal RAC efforts to re-open payment decisions, court says

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Medicare service providers cannot object to a Medicare Recovery Audit Contractor's (RAC) decision to re-open a payment decision, a federal appeals court ruled Tuesday.

Nonprofit providers bear burden of more frequent compliance audits, survey finds

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Nonprofit healthcare providers are disproportionately targeted by outside compliance audits when compared to their for-profit counterparts, a new report asserts.

Lawmakers blast federal efforts to monitor and police Medicare fraud -- again

Lawmakers blast federal efforts to monitor and police Medicare fraud -- again

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Lawmakers again hammered the Centers for Medicare & Medicaid Services' Medicare program integrity contractors Friday. The latest salvos were fueled by an agency admission that additional mistakes had been made.

Senators: Recovery audit contractors might be doubling up tasks; campaign against fraud gears up

Senators: Recovery audit contractors might be doubling up tasks; campaign against fraud gears up

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Members of the Senate Finance Committee say they are concerned that the functions completed by independent contractors — known as recovery audit contractors (RACs) and Zone Program Integrity Contractors (PICs) — often overlap.

CMS awards 26 states with Medicaid audit contracts

CMS awards 26 states with Medicaid audit contracts

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Contracts for Medicaid recovery audit contractors (RACs) have been awarded to 26 states, government officials have announced.

McKnight's Online Expo to cover audits, payments for SNFs

Medicare's recovery audit contractors (RAC) program recovered $398 million in overpayments in the first quarter of fiscal year 2012, according to a government report.

CMS provides answers to auditor questions

Medicaid Recovery Audit Contractors will not be replacing existing program integrity contractors, according to new guidelines from the Centers for Medicare & Medicaid Services.

National Medicare RAC Summit to uncover answers on Monday

The 6th National Medicare RAC Summit will be held Monday in Washington. The pre-conference Recovery Audit Contracting "boot camp" will run from 8 a.m. to 12 p.m. and delve into industry best practices. The main program will run from 1 p.m. to 5:30 p.m. and feature sessions on topics such as audit strategies of the Office of Inspector General and the top 10 inpatient and outpatient issues of interest to Medicaid auditors. The event will take place at the Renaissance Washington, DC, Downtown Hotel.

CMS finds group to conduct recovery audits

The Centers for Medicare & Medicaid Services has hired a contractor to conduct recovery audit functions on Medicare Part D drug plan, according to the Bureau of National Affairs.

Medicaid audits the focus of new website

Medicaid audits the focus of new website

Providers and other stakeholders can learn more than ever about states' Medicaid Recovery Audit Contractor (RAC) programs thanks to a new website launched by the Centers for Medicare & Medicaid Services. The RAC program was created to recover improper payments and also identify underpayments. Medicaid is the No. 1 payer of nursing home services in the United States.

U.S. announces new Medicaid audit program aimed at preventing fraud

U.S. announces new Medicaid audit program aimed at preventing fraud

The Centers for Medicare & Medicaid Services announced late Friday new rules aimed at stopping improper Medicaid payments to providers. Taking a page from the Medicare program, regulators have proposed using Medicaid Recovery Audit Contractors (RACs).

Nurse administrators meet to hone survey skills, examine culture change

Directors of nursing are going to be told from Saturday to Wednesday that they "can do whatever they put their mind to" at the annual meeting of the National Association Directors of Nursing Administration / Long-Term Care, organizers say. Themed "Mission Possible," the meeting takes place in Phoenix and will feature workshops focusing on Recovery Audit Contractor (RAC) surveys, culture change and Quality Indicator Surveys (QIS). The keynote speaker will be LeAnn Thieman, co-author of "Chicken Soup for the Nurses Soul."