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• CMW news: Providers report first RAC denials in Florida, South Carolina

  Healthcare providers are starting to share their interactions with recovery audit contractors (RACs).

• ‘Making case management history’ one story at a time

  Because case managers have such an intimate knowledge of the healthcare system, they are certainly qualified to comment on what works and what doesn’t. That is why the CMSA Public Policy Committee is doing its part to shape healthcare reform.

• Traveling exposes case manager to many models

  Travel nursing is ideal for healthcare professionals who want to explore the country while continuing their careers and gaining valuable experience.

• Pilot program identifies the cause of frequent ED visits; patients overcome barriers

  For many facilities the emergency department (ED) is a chaotic and crowded place.
  Making things worse, there is a population of patients that use the emergency department as their main access point to healthcare.

• Could RAC mass adjustment changes mean increase in automatic audits?

  Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, but no such limits exist for the number of automatic reviews RACs can perform.

• CMW news: House approves healthcare reform bill

  The U.S. House of Representatives recently passed the healthcare reform bill (HR 3962) by a narrow margin (220–215). The bill's estimated cost is more than $1 trillion over the next 10 years.