Health Information Management

News: Lackluster RAC returns could spur fourth quarter records rush

CDI Strategies, September 2, 2011

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To make up a gap in expected overpayment collections Recovery Audit Contractors may escalate audit activities in the coming months, according to an article by Vickie Axsom-Brown, a former RAC Region D vice president published in RAC Monitor.

In 2011, the RAC aimed to accomplish nationally, in one year, what it had done in three states—New York, Florida, and California—over the course of its Demonstration project, according to the article. The Demonstration project targeted the states with the greatest opportunity of fraud and abuse and the largest Medicare population.
“Essentially they stacked the deck in their favor to begin with. The RAC are just not going to find the same level of fraud opportunities in Idaho as they did in the Demonstration states,” says Trey La Charité, MD, Physician Advisor, for University of Tennessee at Knoxville.
If Axsom-Brown’s predictions prove true “I would expect a great deal more chart requests (and more work for us all) in the fourth quarter as the RACs try to make up the short fall,” says La Charité. “In my opinion, there is no way they can get there.”

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