Controversial Medicare auditors group changes name, website
By
John Hall
Mar 02, 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.
RAC audit abuse answers vary
By
John O'Connor
Dec 15, 2014
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...
Long-term care groups applaud a pause in Medicare audits, urge permanent changes
By
Tim Mullaney
Feb 21, 2014
Long-term care stakeholders are praising the government’s decision to temporarily pause the recovery audit contractor program, which is associated with a huge backlog of Medicare claims appeals.
Overdocumentation and cloning in electronic health records are overlooked risks, investigators say
By
Tim Mullaney
Jan 09, 2014
Auditors reviewing Medicare and Medicaid claims from electronic health records are largely treating them in the same manner as paper claims, even though they pose unique risks for overbilling and fraud,...
Ask the legal expert … about using external auditors
By
John Durso
Jan 01, 2014
What do you advise about using external auditors to check what we’re doing — before wave after wave of government auditors come in?
RACs push back against audit improvement bills
By
McKnight's Staff
Jun 06, 2013
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...
Court upholds $5.75 million verdict against former nursing home officers, board members
By
McKnight's Staff
May 24, 2013
A $5.75 million verdict will stand and there will be no new trial in the case against officers and board members of a former Pennsylvania nursing home, a federal judge recently ruled.
ZPICs: Dangerous and ready to take down providers
By
Elizabeth Newman
Jul 24, 2012
Healthcare reform: No matter how much you may loathe it, there’s no way around how certain ideas, like pay for performance, aren’t going away.
Medicare auditors can request twice as many SNF medical records
By
McKnight's Staff
Mar 20, 2012
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.
U.S. announces new Medicaid audit program aimed at preventing fraud
Nov 08, 2010
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...