Document Detail


RAC attack--Medicare Recovery Audit Contractors: what geriatricians need to know.
MedLine Citation:
PMID:  20662954     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Knowledge of Medicare policies and procedures is integral to the practice of geriatric medicine. Within the past several years, there has been a focus on Medicare fraud, abuse, and waste in healthcare spending. One program, Medicare Recovery Audit Contractors (RAC), has recently been launched to identify improper payments by performing postpayment reviews of Medicare Part A and Part B claims. During the program pilot project in only three states, more than $1 billion in incorrect payments were identified, with the overwhelming majority being overpayments that had to be returned to the Medicare Trust Fund. In 2006, Congress mandated that the RAC program be rolled out nationwide, which is ongoing. The audit focuses on documentation of medical necessity for inpatient admission and the 3-day qualifying stay for skilled nursing care, important concerns for geriatricians. This article describes the RAC program and target areas for payment recoupment, denials management, and provider preparation.
Authors:
Deborah W Robin; Randy J Gershwin
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Publication Detail:
Type:  Journal Article     Date:  2010-07-19
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  58     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-10-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1576-8     Citation Subset:  IM    
Copyright Information:
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
Affiliation:
Department of Medicine, School of Medicine, Vanderbilt University, Nashville, Tennessee 37232, USA. debby.robin@vanderbilt.edu
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Comments/Corrections
Comment In:
J Am Geriatr Soc. 2010 Aug;58(8):1591-2   [PMID:  20942874 ]

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