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NEWS: CMS delays RAC permanent program

Patient Access Weekly Advisor, November 5, 2008

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CMS yesterday announced it has delayed the Medicare Recovery Audit Contractor (RAC) permanent program and put a moratorium on all RAC-relayed informational sessions across the country. CMS has yet to release further details but told the American Hospital Association the action was necessary due to “a RAC protest and a stay of performance.”

However, the California Hospital Association (CHA), in a memorandum obtained by HCPro., Inc, says that PRG Schultz (PRG), a contractor that submitted a bid for work in the permanent program but wasn’t selected as one of the four permanent contractors, was considering a challenge to the contract award process.

Despite the delay in the process, Joseph Zebrowitz, MD, executive vice president of Executive Health Resources in Newtown Square, PA, warns facilities not to change anything in terms of preparing for a RAC visit. The permanent program will not change, he says.

“Basically, this is infighting amongst CMS potential contractors who are upset that they were not awarded the RAC contract,” Zebrowitz says. “I think it is important that this delay is not because of any question of whether the RACs are fair, or good, or legal. The RAC program is unchanged, and there is nothing out there to say that anything is going to be different. [CMS] just can not start when the contractors are in doubt. Once they resolve these complaints, they will start up.”

Zebrowitz guessed the delay would take 30 to 60 days.

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