CMS has updated the Medicare Recovery Audit Contractor program's statement of work, responding to calls of increased program collections, according to an AHA News Now report.
The SOW added the following provisions:
• CMS' oversight of the RACs has been increased to guarantee workloads are met.
• RACs will review all types of Medicare providers and claims.
• RACs will review all healthcare providers referred by CMS and other government auditors.
• Semi-automated review is established, which will allow RACs to gather additional information from providers before making automated denials.
How to Navigate the RAC Appeals Process
AHA: 93% of RAC Complex Denials Involve Medical Necessity
The SOW added the following provisions:
• CMS' oversight of the RACs has been increased to guarantee workloads are met.
• RACs will review all types of Medicare providers and claims.
• RACs will review all healthcare providers referred by CMS and other government auditors.
• Semi-automated review is established, which will allow RACs to gather additional information from providers before making automated denials.
Related Articles on RACs:
CMS Increases RAC Record Request Limit for Providers With Low Medicare ClaimsHow to Navigate the RAC Appeals Process
AHA: 93% of RAC Complex Denials Involve Medical Necessity