Home Health & Hospice Week

Keep a wary eye on what Medicare's Recovery Audit Contractors are doing now, because they appear to be gearing up to focus on small providers.

Medicare RACs can now request more records for complex reviews. "Under the previous formula, providers ... with a lower volume of claims would only be required to submit one or two claims per a 45 day period," says accountant Janice Potter with FR&R Healthcare Consulting Inc. in Deerfield, Ill., which covered this topic in a September client bulletin. "This would not make for a valid sample for the RACs to review. Using the new rules, the minimum number of records to be requested is 35 claims," Potter tells Eli.

Watch out: FR&R believes "the change was specifically made to enable RACs to look at SNFs and other small providers," Potter adds.