The Medicare Recovery Audit Program identified and corrected more than 1.1 million claims for improper payments worth $2.57 billion in fiscal year 2014, according to a new Centers for Medicare & Medicaid Services report.
Long-term care providers may not leapfrog standard administrative appeals in Medicare reviews, as one creative Louisiana nursing home was reminded last week.
A federal appeals court last week ruled that the Centers for Medicare & Medicaid Services violated federal contracting regulations when it stretched out payment terms for recovery audit contractors.
Recovery Audit Contractors making incorrect accusations should also be penalized, the American Medical Association is telling lawmakers and regulators. Physicians, long-term care operators and other providers have long criticized the RAC system, which rewards the government's contracted investigators based on the volume of "improper payments" they point out.
Recovery Audit Contractors collected $1.8 million in Medicare overpayments made to skilled nursing facilities in fiscal year 2013, according to a Congressional report released in late September.
Recovery Audit Contractors recovered $1.8 million in Medicare overpayments made to skilled nursing facilities in fiscal year 2013, according to a Congressional report released Monday.
The government should pay for skilled nursing care without a preliminary three-day hospital stay, and the recovery auditor program should be reformed, Medicare Payment Advisory Commission members said at a meeting Friday.
Medicare Recovery Audit Contractors returned a record $100.4 million in identified underpayments to providers between April and June.
Long-term care and other providers could be facing unfair burdens due to ineffective government oversight of Medicare auditors, according to a new report from a federal watchdog agency.
There is no easy fix to the staggering backlog of Medicare appeals, a government official said during a July 10 Congressional hearing.
Medicare Recovery Audit Contractors returned $100.4 million in underpayments to healthcare providers in the third quarter of fiscal year 2014, the Centers for Medicare & Medicaid Services has announced.
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.
I thought the Recovery Audit Contractors (RACs) were on hold. Why did we still get a request for records?
RACs were 'most improved' healthcare auditors for getting back money in 2013, government report statesApril 18, 2014
Medicare Recovery Audit Contractors dramatically stepped up their overpayment recoveries last year, returning nearly $487 million more to the government than they did in 2012, according to a new report from a federal watchdog agency.
Medicare recovery audit contractors collected about $8,000 in fiscal year 2012 through a skilled nursing facility claims review pilot, according to a recently released annual report to Congress.
Government investigators claim — and the Centers for Medicare & Medicaid Services concurs — that more consistency is needed with Medicare post-payment claims reviews.
Independent Medicare auditors are criticizing two measures that would put stricter controls on Recovery Audit Contractors.
An advocacy group for independent Medicare auditors has sharply criticized two bills that would put new controls on Recovery Audit Contractors. The Medicare Audit Improvement Act of 2013 was introduced in the House of Representatives in March. A Senate version of the bill was introduced last month. The bill would rein in auditors and improve transparency, which have been provider concerns.
A new Senate bill addresses provider concerns over the Medicare audit process, including the role of Recovery Audit Contractors. The House is also considering a version of the "Medicare Audit Improvement Act of 2013," which lawmakers originally introduced in October 2012 and reintroduced in March.
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.
Medicare recovery audit contractors (RACs) can request as few as 20 records in a 45-day period from skilled nursing facilities and other providers as of April 15, according to the Centers for Medicare & Medicaid Services. This is a reduction from the current 35-record minimum request.
TODAY'S THE DAY: McKnight's Online Expo kicks off with session on MDS 3.0 as lawmakers reintroduce audit billMarch 20, 2013
Representatives Sam Graves (R-MO) and Adam Schiff (D-CA) recently reintroduced a bill to ease audit burdens on long-term care providers. Initially put forward in Oct. 2012, the Medicare Audit Improvement Act would change the way Medicare recovery audit contractors (RACs) operate.
There are plenty of legal concerns that keep nursing home administrators awake at night. Many times, the demons can be kept under the bed or locked in the closet. But not always.
It's interesting how competition can make strange bedfellows. Nursing homes and hospitals, for example, are next-door-neighbors on the caregiving block. We all know who has the bigger house on this block, and it often creates resentment.
The Medicare contractors keeping close tabs on long-term care facilities will be subject to oversight too, according to a federal working plan released this week.
Requests for medical records by Medicare's fraud-detecting recovery audit contractors (RACs) jumped sharply from the first- to the second-quarter of fiscal year 2012, a new survey reveals.
Medicare recovery audit contractors have not been diligent enough in collecting previously identified overpayments, a government investigation finds.
Recovery audit contractors and other quality assurance efforts allowed Medicare Advantage to reduce improper payments by $1.2 billion in 2011, according to a new government report.
More communication is needed between Medicare and Medicaid's respective program integrity officials, a new report suggests.
Medicare recovery audit contractors (RACs) can now request twice as many resident medical records than previously allowed, according to the Centers for Medicare & Medicaid Services.