Tag Archives: Recovery Audit Contractors

Another Delay for the Two-Midnight Rule

The Centers for Medicare and Medicaid Services (CMS) announced, on August 12, 2015, that it has extended the enforcement delay of the controversial two-midnight rule governing short hospital stays until the end of the year. As set forth in the FY 2014 IPPS Rule, the two-midnight rule imposes financial penalties for services that recovery auditors deem … Continue reading this entry

GAO Issues Report on Post-Payment Claims Reviews by CMS Contractors

Compliance
The U.S. Government Accountability Office (GAO) recently issued a report entitled “Medicare Program Integrity: Increased Oversight and Guidance Could Improve Effectiveness and Efficiency of Post-Payment Claims Reviews,” which analyzes the processes used by the Centers for Medicare & Medicaid Services (CMS) to avoid the duplication of post-payment claims reviews by its contractors. GAO’s report focused … Continue reading this entry

Recovery Audits Cease as CMS Introduces New Provider-Friendly Contract Terms

February is the last date Recovery Audit Contractors (RACs) and Medicare Administrative Contractors (MACs) can issue additional documentation requests (ADRs) as the current Recovery Audit Program contracts are coming to a close. This will give providers a much-needed “intermission” in recovery audits until the Centers for Medicare and Medicaid Services (CMS) finalize and select winning bidders … Continue reading this entry