Reps. Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) have proposed the Medicare Audit Improvement Act of 2012, a bill that would restructure the way Medicare Recovery Auditors — formerly known as recovery audit contractors — can review providers.
The bill would establish annual limits on documentation requests from RACs, impose financial penalties on RACs if they fell out of compliance with program requirements, make RAC performance evaluations publicly available and allow denied inpatient claims to be billed as outpatient claims if necessary, among other measures, according to an AHA News Now report.
The American Hospital Association supported the bill, saying it would scale back the RAC program that has perhaps outgrown its purpose. "No one questions the need for auditors to identify billing errors, but the flood of new auditing programs…is drowning hospitals with a deluge of redundant audits, unmanageable medical records requests and inappropriate payment denials," Rick Pollack, AHA's executive vice president, wrote in a letter.
The bill would establish annual limits on documentation requests from RACs, impose financial penalties on RACs if they fell out of compliance with program requirements, make RAC performance evaluations publicly available and allow denied inpatient claims to be billed as outpatient claims if necessary, among other measures, according to an AHA News Now report.
The American Hospital Association supported the bill, saying it would scale back the RAC program that has perhaps outgrown its purpose. "No one questions the need for auditors to identify billing errors, but the flood of new auditing programs…is drowning hospitals with a deluge of redundant audits, unmanageable medical records requests and inappropriate payment denials," Rick Pollack, AHA's executive vice president, wrote in a letter.
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