Medicare auditors can request twice as many SNF medical records
Medicare recovery audit contractors (RACs) can now request twice as many resident medical records than previously allowed, according to the Centers for Medicare & Medicaid Services.
View ArticleMore collaboration between Medicare and Medicaid fraud detection programs is...
More communication is needed between Medicare and Medicaid's respective program integrity officials, a new report suggests.
View ArticleReport: Improper Medicare Advantage payments fell $1.2 billion in 2011
Recovery audit contractors and other quality assurance efforts allowed Medicare Advantage to reduce improper payments by $1.2 billion in 2011, according to a new government report.
View ArticleLow-quality Medicare Advantage plans should expect scrutiny, CMS says
Medicare Advantage plans with fewer than five stars on the quality scale should expect some form of audit, a Centers for Medicare & Medicaid official said this week.
View ArticleOIG: Regulators need to sharpen retrieval of Medicare overpayments made to...
Medicare recovery audit contractors have not been diligent enough in collecting previously identified overpayments, a government investigation finds.
View ArticleLawmakers blast federal efforts to monitor and police Medicare fraud -- again
Lawmakers again hammered the Centers for Medicare & Medicaid Services' Medicare program integrity contractors Friday. The latest salvos were fueled by an agency admission that additional mistakes...
View ArticleMedicare auditors becoming more active, denying more claims, survey shows
Requests for medical records by Medicare's fraud-detecting recovery audit contractors (RACs) jumped sharply from the first- to the second-quarter of fiscal year 2012, a new survey reveals.
View ArticleOIG: Medicare contractors, antipsychotics in SNFs to get a closer look
The Medicare contractors keeping close tabs on long-term care facilities will be subject to oversight too, according to a federal working plan released this week.
View ArticleLaws and policies in focus next week for LTC therapy and ancillary services...
A keynote address by Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology, will highlight opening day of the annual winter Legislative and Regulatory Conference of the...
View ArticleTODAY'S THE DAY: McKnight's Online Expo kicks off with session on MDS 3.0 as...
Representatives Sam Graves (R-MO) and Adam Schiff (D-CA) recently reintroduced a bill to ease audit burdens on long-term care providers. Initially put forward in Oct. 2012, the Medicare Audit...
View ArticleAHCA opposes manual review system for therapy claims, launches provider...
As part of its pushback against the manual review process for therapy claims, the American Health Care Association has launched a clearinghouse to gather provider feedback. AHCA President Mark...
View ArticleCMS announces lower minimum request limit for recovery audit contractors
Medicare recovery audit contractors (RACs) can request as few as 20 records in a 45-day period from skilled nursing facilities and other providers as of April 15, according to the Centers for Medicare...
View ArticleCMS explains therapy cap notification requirement, but more guidance needed,...
A recent Centers for Medicare & Medicaid memorandum provides some clarity regarding new therapy cap notification rules, but providers still need guidance on other aspects of therapy reimbursement,...
View ArticleRAC transition: Fewer document requests but no slowing of therapy reviews,...
Providers will see fewer Additional Document Requests starting in June, as the Centers for Medicare & Medicaid Services transitions to new Recovery Audit Program contracts. CMS has started the...
View ArticleRACs push back against audit improvement bills
An advocacy group for independent Medicare auditors has sharply criticized two bills that would put new controls on Recovery Audit Contractors. The Medicare Audit Improvement Act of 2013 was introduced...
View ArticleBill calls for faster action on RAC reports, more 'expert' Medicaid oversight
The Centers for Medicare & Medicaid Services should move faster to make changes based on Medicare audits and should have more direct oversight over Medicaid, according to bipartisan legislation...
View ArticleAsk the payment expert ... about RAC nursing home audits
We keep hearing about RACs in skilled nursing homes but we haven't seen any in our state, so why should we worry about them?
View ArticleRAC program needs better oversight, Inspector General report finds
Recovery audit contractors might be better at reviewing Medicare claims than critics allege, but the Centers for Medicare & Medicaid Services could improve RAC performance evaluations, according to...
View ArticleFeds ease auditing reviews, anti-fraud efforts to surge
Providers likely will embrace House legislation that eases billing reviews for operators deemed a low fraud risk.
View ArticleMedicare appeals at the administrative law judge level will be suspended for...
Long-term care providers filing to have a Medicare claims appeal heard by an administrative law judge will not have the case assigned to a judge for at least two years, according to the Office of...
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