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Home Health & Hospice Week

Industry Note:

Recovery Audit Contractor Prepayment Reviews Start This Month

Published on Thu Aug 23, 2012

Now that Recovery Audit Contractors have named home health agencies as specific targets (see Eli's HCW, Vol. XXI, No. 29), you might want to pay attention to a new RAC initiative that could threaten your cash flow.Starting Aug. 27, CMS will begin its Recovery Audit Prepayment Review prepayment audits in 11 states, the agency says on its website. This program will allow RACs "to review claims before they are paid to ensure that the provider complied with all Medicare payment rules," according to CMS. "The RACs will conduct prepayment reviews on certain types of claims that historically result in high rates of improper payments. These reviews will focus on seven states with high populations of fraud- and error-prone providers (FL, CA, MI, TX, NY, LA, IL) and four states with high claims volumes of short inpatient hospital stays (PA, OH, NC, MO) for a total of 11 states. This demonstration [...]
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