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Home Health & Hospice Week

Audits:

Medicaid RACs Slated To Fire Up This Year

Published on Wed Apr 07, 2010

Will the new Medicaid bounty hunters duplicate MIC scrutiny? If you submit claims to Medicaid, get ready for another set of eyes looking over your shoulder. The Patient Protection and Affordable Care Act (PPACA) calls for every state Medicaid program to contract with at least one Recovery Audit Contractor to review claims. That totals a minimum of 56 Medicaid RACs, points out consultant Tom Boyd with Rohnert Park, Calif.-based Boyd & Nicholas. Like their federal counterparts, Medicaid RACs would be paid on a contingency fee basis. That means their fee would be based on a percentage of the funds they recover. However, they also would receive a set fee for cases in which they find underpayments, adds the health care reform law that was enacted in March. Health care providers have roundly criticized this bounty hunter model of payment, which encourages RACs to make unnecessary recoupments, they say. The new [...]
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