decisionhealth Newsletters, Part B News - 2009 Issue 6 (June)
RACs have yet to send out new records requests, CMS tells PPAC
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Article Overview
This article reports on CMS comments to the Practicing Physicians Advisory Committee about the rollout of the Recovery Audit Contractor program for Medicare providers. It covers the status of outreach, record-request activity, approved review targets, automated reviews, and administrative limits and logistics relevant to providers and practices. The piece is useful for physicians, billing staff, compliance teams, and anyone tracking RAC program implementation and Medicare audit activity.
Why This Topic Matters
Providers need to understand when RAC activity is expected, how requests may be issued, and what operational limits CMS is considering. The article highlights Medicare audit administration details that can affect records handling, workflow, and compliance planning.
Article Sections
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CMS clarification on RAC record requests
CMS addresses confusion about recent records requests and the timing of RAC communications. The section explains the current rollout status and the distinction between different Medicare-related request sources.
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Outreach stage and approval process
This section covers the current implementation phase of the RAC program and CMS approval requirements for targeted review activity. It also notes the role of pilot studies and posted approved targets.
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CMS responses to recommendations
PPAC recommendations and CMS responses are summarized, including record-request limits and reimbursement-related concerns. The section also discusses record submission logistics and planned online upload capabilities.
What You Will Learn
- The current status of CMS outreach for the Recovery Audit Contractor program
- How RAC record requests and targeted reviews are being managed during rollout
- What administrative issues PPAC raised about record limits and copying costs
- Which provider workflow considerations are associated with RAC record submission
Who Should Read This
- Physicians and physician groups
- Medical billing and coding staff
- Compliance and revenue cycle teams
- Practice administrators
- Healthcare policy and audit professionals
Modifiers Discussed
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