Part B Insider (Multispecialty) Coding Alert
CMS Moves to Make RAC Program Permanent After Recovering Almost $700 Million
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Plus: CMS halts PQRI confusion with new laminated reference tool outlining measures and reporting periods In other news ... - If you want to get your cut of the approximate $36 million paid to PQRI participants last year, you might benefit from a handy reference tool that CMS recently created.
If you-ve been hoping that CMS- recovery audit contractor (RAC) program would just go away, it's time to face some bad news.
On July 14, CMS announced that the RAC program has brought in $693.6 million from just six states since 2005, and that the agency plans to roll it out across the nation over the next two years.
-Because of the success of the recovery audit contractor pilot, Congress has made the program permanent and required its expansion throughout the country,- said Acting CMS Administrator Kerry Weems in a July 14 statement.
Many practices consider the RACs -bounty hunters- because they collect a -contingency fee- for the money that they collect. CMS claims to have prepared for such criticism by planning some changes in the program.
CMS intends to appoint a RAC validation contractor to conduct third-party reviews of the RAC claim determinations, Weems said in his statement. In addition, the RACs will be limited to performing claims reviews only over the three year period prior to the review date.
To read more about the RAC program, go online to www.cms.hhs.gov/RAC.
Many Medicare-participating practices were confused about which conditions were eligible for the PQRI program and which weren-t. CMS took the guesswork out of the equation by offering a new laminated reference chart.
The document not only lists the applicable PQRI measures, but also corresponds each measure to its reporting period.
To read more about the product, visit www.cms.hhs.gov/PQRI/Downloads/PQRIQuickReferenceChart.pdf, and to place an order for it, go to http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5.
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CMS Moves to Make RAC Program Permanent After Recovering Almost $700 Million
Plus: CMS halts PQRI confusion with new laminated reference tool outlining measures and reporting periods
If [...]