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Home Health & Hospice Week

Compliance:

RAC Bounty Hunters Take Aim At Medicaid Claims

Published on Fri Feb 18, 2011

Recent delays give you more time to plan for these audits. If you've been ignoring RACs because Medicare contractors have largely overlooked home care topics, it's time to pay attention. Get ready for a whole new wave of recovery audit contractor audits, thanks to last year's Patient Protection and Affordable Care Act and its requirement for Medicaid RACs. In place for Medicare contractors since 2005, RACs are often referred to as medical "bounty hunters" because they make money only if they collect overpayments from you. Their income is specifically tied to the amount they recover, and is based on a percentage of the overpayments they identify. Medicare RACs have investigated only a small number of topics tangentially related to home care and hospice, including "DME while in Hos-pice," "Hospice Related Services -- B," and "Medi-cal Supplies and Home Health Consolidated Billing" (see Eli's HCW, Vol. XIX, No. 9, p. 66). [...]
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