CMS RAC Demonstration Project Postponed Until June February 6, 2012

The Centers for Medicare and Medicaid Services (CMS) Recovery Audit Prepayment Review (RAC) Demonstration project was scheduled to begin on January 1, 2012 and was delayed in December by the Agency for further review.

(more…)

Audit Alphabet Soup: MACs, RACs and Pre-Payment Reviews January 11, 2012

To navigate the constantly changing current of Medicare audits, it is critical that the heart rhythm care community understands the distinction between a Medicare Administrative Contractor (MAC)-driven review and a Recovery Audit Contractors (RAC) review. (more…)

Update: RAC Demonstration Project January 5, 2012

The Center for Medicare and Medicaid Services has announced that it will delay until further notice the Recovery Audit Prepayment Review Demonstration Project. The prepayment review was scheduled to begin on January 1, 2012 in eleven states (FL, CA, MI, TX, NY, LA, IL, PA, OH, NC, MO).  This week’s announcement states that the CMS received many comments/suggestions,  that it is “considering these comments carefully, ” and that it will provide at least 30 day notice before the demonstrations begin. (more…)

Clarification: CMS RAC Demonstration Project; Florida Prepayment Review December 6, 2011

In late November, the Centers for Medicare and Medicaid (CMS) announced plans for a prepayment review demonstration project in 11 states beginning in January 2012.  In a separate action and at about the same time, First Coast Service Options, the Medicare Administrative Contractor for the State of Florida announced that it will conduct 100 percent prepayment review of charges for 15 diagnosis-related groups beginning in January 2012.  These announcements have created considerable confusion about two distinct efforts.  Articles in Heartwire, Bloomberg, and Forbes have led to uncertainty in the physician community about whether these actions are the same or different. (more…)