Medicare Compliance & Reimbursement

Payment Trends:

Beware: RACs May Be Triggering MAC Attacks

If you do get a notice of a probe review, don't do this. SNF providers may not be the only ones worried about RACs on the prowl for overpayments. Numerous consultants are seeing more MAC/FI probe reviews, which they say may signal that Medicare contractors are ramping up their efforts to detect overpayments before RACs get the chance. "It could be that MACs are feeling pressure from the RAC audits" to do more post-payment reviews, which may be a self-preserving effort "to keep their contracts with CMS in good standing," surmises Sherri Robbins, RN, BSN , supervising consultant with BKD LLP in Springfield, Mo. She notes that the MAC in her region is doing more post-payment reviews, creating panic among SNF providers. FR&R Healthcare Consulting has also been seeing quite a few probe reviews from NGS and Wisconsin Physician Services, reports Betsy Anderson, VP for the firm in Deerfield, Ill. [...]
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