Members of Congress request GAO study on RACs program
Healthcare Auditing Weekly, July 22, 2008
Four congressmen and one congresswoman are asking the Government Accountability Office (GAO) to conduct a study on the private Medicare Recovery Audit Contractor Program.
In a letter to Hon. Gene Dodaro, acting U.S. Comptroller General, Congressmen John Dingell (D-MI), Charles Rangel (D-NY), Pete Stark (D-CA), and Frank Pallone (D-NJ), and Congresswoman Lois Capps (D-CA) stated congress received several reports of problems with the RAC initiative during the pilot program, which began in 2004.
Problems included:
- Poor communication from RAC contractors
- Unqualified personnel, review practices inconsistent with Medicare policies
- A contingency fee that was inherently prone to contractor abuse
Although many of these problems have been addressed by CMS, the politicians said in the letter, “given the substantial challenges to that arose during the pilot program, and notwithstanding the significant changes to the program going forward, we believe it is important that the RAC experience be reviewed.”
They are asking specifically that the following changes be incorporated in the nationwide rollout in 2010:
- Provider outreach and actions the agency has taken to prevent future improper payments in areas identified by RACs
- Coordination and interaction with other Medicare contractors
- CMS oversight of auditing efforts
- CMS oversight of interaction between the recovery audit contractors and providers done to quantify and minimize the total burden of compliance.
Comments
0 comments on “Members of Congress request GAO study on RACs program ”
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Level of encryption needed for email
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Q&A: Acute respiratory failure diagnosis does not require intubation
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- Oxygen Cylinder Storage Requirements
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Understand the spine to code back procedures correctly
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Searched