Prepare for the recovery audit contractors now for audit success later
Briefings on Outpatient Rehab: Reimbursement and Regulations, July 1, 2009
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The congressionally mandated RAC program, which was implemented to identify and correct past improper Medicare payments, is not new. Initially, it began as a three-year demonstration in California, Florida, and New York in 2005, before expanding to Massachusetts, South Carolina, and Arizona in 2007.
The RAC demonstration ended in March 2008 and, according to a report released by CMS in June 2008, The Medicare Recovery Audit Program: An Evaluation of the Three-Year Demonstration, a total of $980 million in overpayments to providers was corrected.
The amount of overpayments providers were required to return to the Medicare Trust Fund incited panic among the healthcare industry. However, therapists who learn from the mistakes of others and enact prevention techniques, such as internal reviews, correct coding training, and staff education, will be better prepared for the expanding RAC program.
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