Who Audits the Auditors?

Two thousand years ago the Roman poet Juvenal asked, “Who watches the watchmen?” (Satires, VI, line 346). Since the advent of Medicare in 1965, hospitals have bemoaned the cost and burden of Medicare audits.  The complaints increased when CMS hired private contractors for the audits.  They became …

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Brace Yourself: The RACs Are Back

Yesterday the Centers for Medicare & Medicaid Services announced that it will restart the Recovery Audit Contractor (RAC) program this month, on a limited basis.  It’s been on hold since June. Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent …

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GOT A COMPLAINT ABOUT RAC AUDITS? GET IN LINE

Criticism of the RAC (recovery audit contractor) program is becoming a national pastime.  Needless to say, hospitals hated the program from the very beginning.  And little wonder.  The program pays private contractors a percentage of everything they recover through Medicare audits.  Critics say that’s like …

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The RAC Wars – The Latest Shot

The latest shot in the war between hospitals and RACs has been fired.  The American Hospital Association (AHA) and four hospital systems brought a lawsuit against the Department of Health and Human Services (HHS), alleging that the government’s recovery audit contractor (RAC) program improperly demands …

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The ZPICs are Here! Is Your Organization Ready?

Effective April 24th, 2012, Cahaba Safeguard Administrators, LLC, the Zone Program Integrity Contractor (ZPIC) for Zone 3, is fully operational.  Zone 3 includes the following states: Minnesota, Indiana, Michigan, Illinois, Ohio, Wisconsin and Kentucky.  Implementation of a ZPIC contractor in Zone 3 was delayed …

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CMS Launches Medicaid RAC Website

The Centers for Medicare & Medicaid Services (CMS) launched a new website entitled “State Medicaid RAC’s At-A-Glance.” The website contains a map of the United States, and is designed to track implementation of the Medicaid Recovery Audit Contractor (RAC) program in each state. By hovering the cursor …

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