Delayed RAC review demo to begin in June
The Centers for Medicare & Medicaid Services (CMS) announced that its Recovery Audit Prepayment Review Demonstration will move forward by June 1.
The demonstration initially was scheduled for a January 1 implementation date but was delayed due to provider concerns.
The project allows recovery audit contractors (RACs) to review claims before they are paid, focusing on the types of claims historically associated with high rates of improper payments in seven states (California, Florida, Illinois, Louisiana, Michigan, New York and Texas) and claims with high volumes for short inpatient hospital stays in four states (Missouri, North Carolina, Ohio and Pennsylvania).
CMS stated it expects this demonstration to also help lower the error rate by preventing improper payments rather than the traditional "pay and chase" methods of looking for improper payments after they occur.
There were no major changes to the RAC pilot program.
The demonstration initially was scheduled for a January 1 implementation date but was delayed due to provider concerns.
The project allows recovery audit contractors (RACs) to review claims before they are paid, focusing on the types of claims historically associated with high rates of improper payments in seven states (California, Florida, Illinois, Louisiana, Michigan, New York and Texas) and claims with high volumes for short inpatient hospital stays in four states (Missouri, North Carolina, Ohio and Pennsylvania).
CMS stated it expects this demonstration to also help lower the error rate by preventing improper payments rather than the traditional "pay and chase" methods of looking for improper payments after they occur.
There were no major changes to the RAC pilot program.
Beth Walsh,
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.