Health Information Management

News: Recovery Audit Contractors reined in

CDI Strategies, November 15, 2007

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According to a report in AHA News Now, a publication of the American Hospital Association, the Recovery Audit Contractor (RAC) program, scheduled for nationwide implementation in March 2008, may not have the bite that many hospitals feared. On November 7, CMS issued a revised Statement of Work for the program that not only delays implementation for hospitals in some states, but also limits the claims that RAC contractors may review to those with dates of service from October 1, 2007 and forward.

Before the revised Statement of Work, RAC contractors were free to review hospital inpatient and outpatient claims up to four years old.

The RAC contractors currrently operate in California, Florida, and New York, and are paid on a contingency fee basis, meaning that they receive a percentage of the incorrect payments that they identify and collect.

To read the new RAC program Statement of Work, click here.



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