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 accuracy review due to the low volume of claims they submit
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, waste and abuse.
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, the auditors themselves.
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 to be backing down
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.
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.
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 appeals cases.
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 Medical Equipment, Home Health and Hospice, in this new, fifth nationwide region.
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 my children this importance when they hear me talk about my industry and agencies that "audit," and how these agencies freely manipulate or ignore data to derive results they want versus results that are real.
Independent Medicare auditors are criticizing two measures that would put stricter controls on Recovery Audit Contractors.