The number of medical records a recovery audit contractor can request from a provider will take a serious hit starting January 1.
The new annual additional document request limit, released by the Centers for Medicare & Medicaid Services on Friday, is 0.5% of a healthcare facility’s total amount of paid Medicare claims from the previous year. The current limit is 2% of all paid claims. RACs use the requested documents to support claims that are being audited.
The update follows previous measures from CMS to slowly phase out RACs. A report published earlier this month revealed quality improvement organizations are now handling inpatient status reviews, and RACs won’t conduct any future inpatient reviews unless they’ve received a referral from a QIO.
