AHA urges Congress to enact RAC reforms

The American Hospital Association made a number of requests regarding the Medicare Recovery Audit Contractor program in a statement submitted to the Senate Finance Committee for a recent hearing on audit and appeals issues in Medicare.

The AHA urged Congress to take the following action:

1. To remove the financial incentives that encourage RACs to deny claims;

2. Reduce payments to RACs with a high rate of overturned denials;

3. Allow RAC reviews to consider only the medical documentation available when the admission decision was made; and

4. Allow hospitals sufficient time to rebill denied inpatient admissions under Medicare Part B.

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