Health Information Management

RACs are back on track with revised expansion schedule

APCs Weekly Monitor, February 13, 2009

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CMS announced February 6 the permanent RAC program is once again underway as the RAC bid protests filed by Viant, Inc., and PRG Schultz, USA, Inc., have been withdrawn. Viant and PRG’s protests were resolved February 4, so CMS announced it is lifting the stop work order.

 

"If you have put your RAC preparation on hold, it's time to start finalizing your strategy. And it's time to become familiar with the contractor in your area," says Kimberly Anderwood Hoy, JD, CPC, the director of Medicare and compliance for HCPro, Inc.

CMS has revised its RAC expansion schedule, according to the new "RAC Phase In Map" posted February 10 to the CMS Web site. The first phase is set to begin March 1, 2009. The second stage will begin August 1, according to the map.

The previous expansion schedule was set to occur in three stages. However, the now-resolved protests by delayed the initial onset of the permanent RAC program.

“For those hospitals who have a couple of weeks to prepare, I believe one of the biggest challenges is to have well established coordination of denials and appeals and an effective tracking tool,” says Yvonne Focke, RN, BSN, MBA, revenue cycle director at St. Elizabeth and St. Luke Hospitals in Covington, KY. “For those of us who have until August, we’ll have to continue on course with our RAC preparedness, including assessing our gaps, quantifying our risk and establishing a tracking mechanism.”

Editor’s note: To view the decision information on the GAO Web site, visit the GAO Bid Protest Docket and enter file #400443. The CMS Web site has posted additional details on the decision and more general information on the Medicare RAC program.



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