Are You Prepared for a Medicare RAC Attack?

Somebody is poking their nose into your health care business-again! Unless you have been living under a rock for the past few years you most likely are at least generally aware of the Medicare Recovery Audit Contractor (RAC) program. Mandated by Congress as part of the Medicare Modernization Act of 2006, the initial RAC demonstration program was operational for a 3-year period that ended March 27, 2008. A competitive process was used by the Centers for Medicare & Medicaid Services (CMS) to select contractors to fulfill the RAC role. Each RAC was required to adhere to all Medicare policies & regulations when conducting provider claim reviews. In the event there was no Medicare policy that covered a particular claim, RACs were required to review claims against known & accepted standards of care at the time the claim was submitted. [Reprinted by permission of Sage Publications Inc., copyright holder.]