CMS officials say they want RAC program to be fair

To date, the CMS's Recovery Audit Contractor (RAC) program has done little but strike fear into the hearts of providers, many of whom say their experiences with RACs have been less than pleasant. Meanwhile, CMS officials are going about attempting to calm these fears, asserting that they want to make RAC "a fair program" for providers, according to Lt. Terrence Lew, a health insurance specialist with CMS's Division of Recovery Audit Operations, who spoke at a recent panel.

According to Lew, CMS is going to be encouraging the contractors to be "reasonable" in their dealings with providers. Also, the agency itself has changed the program somewhat to reduce the burden on doctors and hospitals, such as limiting how many medical records a RAC interviewer can request. Panel members recommended addition RAC program changes, such as requiring auditors to reimburse providers for copies of medical records prior to the commencement of a RAC audit.

However, providers say that the program as it remains is still very challenging; for example, it's very difficult for small group practices to produce 24 medical records in 45 days to an auditor, according to one audience member. All told, it doesn't sound as though CMS has bent all that far in the direction of calming fearful clinicians and hospitals.

To learn more about CMS and the state of the RAC program:
- read this Modern Healthcare piece (reg. req.)

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