AHA weighs in on Part C RACs
HIM Connection, March 8, 2011
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On February 23, the American Hospital Association sent a letter to CMS regarding the expansion of RAC into Medicare Part C.
The AHA urged CMS to implement the Part C RAC program in a manner that focuses on accuracy of payments from Medicare to the Medicare Advantage (MA)plans instead of requiring MA plans to create a separate RAC program.
In addition, the letter contained 15 recommendations, including:
- Excluding medical necessity review (MNR) from the program
- Requiring trained medical professionals to conduct RAC audits
- Limiting RACs to a 12-month look-back period
- Necessitating close CMS oversight of RACs and specifically assigning CMS staff to address provider concerns with Medicare Advantage plan RACs
- Requiring CMS approval of each audit issue before the RAC conducts the audit
For more information, visit the HCPro Revenue Cycle Institute.
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