Medicare RAC court case keeps collections on uncertain footing The U.S. Court of Appeals for the Federal Circuit issued a decision in early March in a case filed by one of the Medicare Recovery Audit Contractors (RAC) after the Centers for Medicare and Medicaid Services (CMS) changed the timing for the payment of contingency fees on collections. The decision means the auditing program will be put on hold until CMS determines how to contract with its RACs. The RAC program is responsible for identifying fraud and waste in the Medicare system by detecting improper Medicare payments. Since 2008, when ... March 18, 2015 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, Medicare, Recovery Audit Contractor, Audits 0 0 Comment Read More »
Congress passes a number of health care provisions in the current budget Congress narrowly passed a $1.1 trillion federal budget that will fund most of the federal government through September 2015. Below is a summary of key health care provisions in the bill. Within the bill, Congress expressed concern that there had not been adequate opportunity for public comment on bundling of surgical codes in the final rule of the Medicare Physician Fee Schedule. The budget bill says that the appropriate methodology has not been tested to ensure that patient care and patient access are not negatively impacted ... December 16, 2014 General, Medicare Advocacy, Federal Legislation, Medicare, Prescription Drugs, CDC, Ebola, Recovery Audit Contractor 0 0 Comment Read More »
CMS suspends RAC audits, sets up physician safeguards Physicians and hospitals will get a short reprieve from Medicare’s recovery audit contractors (RAC) until next fall, according to the Centers for Medicare & Medicaid Services (CMS). The agency says it is temporarily halting audits as it reevaluates its contracts and implements improvements for physicians. The RAC program is responsible for identifying fraud and waste in the Medicare system by detecting improper Medicare payments. Last month, CMS announced it would pause any new additional document requests (ADR) from RACs until new contracts are settled, in order to reduce provider confusion ... March 19, 2014 Medicare Medicare, RAC, Recovery Audit Contractor, Insurance/Reimbursement 0 0 Comment Read More »
Highlights from AMA's 2013 interim meeting More than 1,000 physicians gathered just outside our nation's capital for the American Medical Association (AMA) interim meeting. The delegates debated a large number of resolutions, establishing new policies related to the Affordable Care Act, culturally and linguistically competent care and the Medicare sustainable growth rate. A number of these resolutions were put forward by the California delegation. Below are highlights of some of the resolutions adopted as policy. Medicare Payment Reform: Following robust discussion in various meeting venues, the AMA House of Delegates passed an amended resolution regarding repeal ... December 3, 2013 General American Medical Association, Cultural Competency, Health Insurance Exchange, ICD-10, Recovery Audit Contractor, SGR, Sustainable Growth Rate, AMA 0 0 Comment Read More »
