What’s Changing with RACs?
- By Brad Ericson
- In Practice management
- May 12, 2014
- No Comments
As prospective recovery audit contractors (RAC) line up to be selected for the next phase of the program, changes to the Centers for Medicare & Medicaid Services’s (CMS’s) Recovery Audit Program continue with a May 7 directive to recovery auditors that the last day they may send claim adjustment files to Medicare administrative contractors (MACs) is June 1, 2014. RACs may complete all discussion periods underway as of June 1, but they will not be required to update their websites with new or approved issues.
These instructions amend others recently posted by CMS as they enter the next round of the procurement process for Recovery Audit Program contracts. Important dates that have already passed include the following:
- February 21 was the last day a recovery auditor could send a postpayment Additional Documentation Request (ADR).
- February 28 was the last day a MAC could send prepayment ADRs for the Recovery Auditor Prepayment Review Demonstration.
- June 1 is the last day a recovery auditor may send improper payment files to MACs for adjustment.
Changes Benefit Providers
Changes to CMS’s Recovery Audit Program rules benefit providers. The agency is changing the confirmation process for communications, the type and number of additional document requests (ADR), and restricting RACs from receiving contingency fees until the second level of appeal is exhausted. Here is a chart with more information:
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Brad Ericson
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