CMS has announced that it will be providing a series of RAC 101 conference calls presented by CMS staff.  These conference calls will be similar to the outreach sessions provided prior to the RAC roll out last year and the content is likely to be the same as the recently posted CMS RAC  101 presentation on You Tube (click here to see it).  However, each call will have a question / answer session which is a good opportunity to get clarification on certain issues.  The call for hospice and home health providers is scheduled for May 4th from 1:00 to 2:30 PM EST.  No registration is necessary.  To join the call dial 1-877-251-0301, meeting ID: 66524952.  For more information about these calls, click here.

The Office of the Inspector General (OIG) issued a report in February 2010 called Recovery Audit Contractors’ Fraud Referrals.  The purpose of the report was to conduct an in-depth study of: 1) the extent to which RACs  referred instances of potential fraud to CMS during the three year demonstration  and 2) the extent to which CMS provided training to the demonstration RACs and the permanent RACs regarding identifying and referring potential fraud.  The results of the report indicate, more than anything, that the OIG wants the RACs to step up their fraud referrals. (more…)

On March 10, 2010, President Obama issued a memorandum to all heads of executive departments and agencies regarding finding and recapturing improper payments.  As part of continuing efforts to combat fraud, waste and abuse throughout the government, President Obama is expanding the the use of  “Payment Recapture Audits.”    Payment recapture audits are what recovery audit contractors (RACs) do to earn their contingency fees.  (more…)

HealthDataInsights (HDI), the RAC for Region D, has posted two approved issues related to hospice. RACs must submit an issue to CMS for approval before it can conduct an automated (without a medical record) or complex (with a medical record) review. CMS has approved two issues related to hospice for HDI to begin reviewing in all of the states in Region D

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It is the end of the year.  It is the end of the first decade of this not so new anymore century.  We can’t resist the temptation to make a list of the Top Ten Hospice Regulatory Challenges of the Past Ten Years.  Here they are - in no particular order: (more…)

The Patient Protection and Affordable Care Act (aka the health care reform bill currently under consideration by the Senate) has implications for the RACs.  Of most relevance in this 2074 page bill is Section 6411 which seeks to expand RACs to Medicare Parts C and D by 12/31/2010.  The RAC program would also be expanded to Medicaid.  (more…)

Very little activity at the RAC Forum to report.  It continues to be available to people who have registered at RAC Assistance for Hospice to share information and questions regarding the RACs.  An interesting question has come up several times that is worth discussing and we could use some help finding answers.

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It continues to be quiet on the hospice RAC front.  There is no RAC activity directed to hospices beyond occasional (very occasional) RAC outreach sessions.  The RAC for Region A (DCS) finally posted some issues on its website and has begun RAC audits.  Interestingly,

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CGI, the RAC for Region B, provided an interesting and informative outreach program on September 9, 2009.  (more…)