Corporate Compliance

Other Issuances: CMS announces RAC selections, OIG issues report on high-dollar claims, and more

Medicare Insider, October 14, 2008

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CMS announces program integrity efforts, contractor selection for the permanent RAC program

On October 6, CMS issued a press release and fact sheet discussing various CMS efforts underway to enhance program integrity. Among other things, these documents highlight recent developments relating to the permanent recovery audit contractor (RAC) program, including the selection of the “Claim RACs” (i.e., claim review contractors) for that program. See Note from Hugh above.

View the press release.

View the RAC program fact sheet.

OIG issues reports on high-dollar payments for inpatient services processed by Palmetto GBA for the period January 1, 2004 through December 31, 2005

On October 7, the OIG issued two reports on high-dollar payments for inpatient services processed by Palmetto GBA, a fiscal intermediary, from January 1, 2004 through December 31, 2005.

View the first OIG report.
 
View the second OIG report.
 
CMS issues memo on Medicare-like rates requirement

On October 3, CMS issued a memo regarding the enforcement of Section 506 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, which requires hospitals and critical access hospitals to accept Medicare-like rates when providing care to individuals who are beneficiaries of Indian Health Service, Tribal health, and urban Indian health programs.

View the memo.



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