RACs Are Coming to Your State! Are You Prepared?
The Centers for Medicare and Medicaid Services (CMS) reported that Medicare has recovered more than $1 billion through the Recovery Audit Contractor (RAC) program since 2005, with 85 percent of the recovered improper overpayments collected from inpatient hospitals.
The RAC demonstration project involved three states — Florida, New York and California and then expanded to include South Carolina and Massachusetts. CMS is required by law to make RAC a permanent, national program by Jan. 1, 2010 with additional state rollouts happening in stages. The program rollout means a much higher level of scrutiny of Medicare reimbursement for hospital inpatient and outpatient, skilled nursing facility, physician, ambulance, laboratory, and durable medical equipment.
Estimated Medicare overpayments exceed $10 billion annually, according to CMS figures from 2007. Based on these estimates, the nationwide RAC program creates a significant potential cost liability for healthcare providers who are forced to turn over all challenged payments immediately, and can only get them back after moving through an appeals process.
Because RACs are paid on a contingency fee basis, receiving a percentage of the improper payments they collect from providers, they are highly motivated to find errors. The program has been criticized at length by hospitals and members of Congress for being a “bounty hunter” initiative.
Join Health Reimbursement Monitor and three diverse RAC experts in the live 90-minute audio webcast, “Preparing for a Medicare RAC Audit: How to Proactively Develop a Defense and Appeal Strategy to Minimize Losses,” that took place in October 2008.
- The differences between the RAC demonstration and the permanent program
- Recognizing the key risk areas identified by the demonstration RACs
- How to determine the financial risk for your organization
- Ways to mitigate potential compliance risk areas
- Nuts and bolts of the RAC claims review and Medicare appeals process
- Who should be on your RAC Response Team
- The importance of clinical staff involvement
- Best practices for appealing RAC determinations
- Case Study: Lessons learned by New York- Presbyterian Hospital during the demonstration project
- How to prepare for the "New" RAC
- Question and Answer
Session
Who Will Benefit From This Audio Webcast?
Hospitals, health systems, PHO’s, labs, consultants, law firms, HIT companies, medical device manufacturers, pharmaceutical companies, with titles like:
CEO, COO, CFO, Executive Directors, Administrators, VP Finance, Chief Compliance Officers and Personnel, Healthcare Auditors, Chargemaster Coordinators, Billing and Claims Generation Staff, Patient Financial Management Personnel, Cost Accounting Staff, Medical Directors, Cost Report Personnel, Financial Analysts, Access Management, Managed Care Contracting, HIM Directors, Coding Managers, Revenue Enhancement Staff, and Others Interested in Compliance
©2008 Health Resources Publishing