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Coming Soon to All Medicare Providers:
RAC Delayed...but Not for Long!
Although the
Recovery Audit Contractor (RAC)
program initiated by the Centers for Medicare and Medicaid
Services (CMS) has suffered a slight delay, the program may very
well be back up and running by February of 2009. This temporary
halt to the work of the RAC contractors is
the result of a protest filed by two unsuccessful bidders. But
the government is due to issue its decision regarding this protest by
early February. So while you have been given a temporary
reprieve, don't expect RAC to stay away from
your door for long - especially as Indiana is first in line for the RAC contractors to come knocking.
The RAC program will affect providers of all
types - hospitals, physician practices of all sizes (from solo
practitioners to large, multi-specialty practices), nursing homes,
hospice programs, home health providers, laboratories, ambulance
service providers, and durable medical equipment suppliers. Any
provider or supplier that bills Medicare Parts A or B for services or
items is fair game for the RAC contractors.
When the RAC contractor contacts you, you won't have very
much time to respond - only 45 days to submit the requested records
or your claims are automatically denied. And if a claim is
denied, you must be prepared to begin the appeal process
immediately. A failure to act within 30 days will
result in CMS withholding amounts from future
reimbursements.
The
professionals at Ice Miller can help you take a proactive approach to
the coming of the RAC contractor in a number
of ways. We can help you focus in on the types of claims the RAC contractor is most likely to survey so that
you can be better prepared to respond fully and promptly. We
can assist you with compliance reviews so that you can start
correcting any problem areas now. And we can help you with
appealing unfavorable determinations.
The RAC process promises to be complicated and costly
for providers, and it is not going to go away. An organized
process for responding to the RAC
contractor's requests and findings is crucial. Contact us now,
before the RAC contractor is at your door.
If
you have any questions, please contact Margaret Emmert,
Myra Selby or your Ice Miller attorney.
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