Ask the expert: Has CMS indicated that it will challenge any successfully appealed Recovery Audit Contractor (RAC) denials?
HIM Connection, June 17, 2008
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A: The AHA recently announced in its June 6 issue of AHA News Now that CMS plans to challenge certain Medicare RAC denials that administrative law judges (ALJ) reversed on appeal in each of the five demonstration states. CMS will pay particular attention to cases in which judges state that RACs lacked good cause to audit claims more than a year old. CMS also told the AHA that it will challenge all good cause ALJ decisions at the Medicare Appeals Council level.
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