Florida shares RAC battle stories

Wondering what it will be like to bear the full force of the Recovery Audit Contractor program? Florida hospital execs can tell you; they've already been with the program for three years as part of the RAC demonstration project.

Recently, Florida Hospital Association CEO Bruce Reuben told FierceHealthFinance what it was like in the RAC trenches. And from what Reuben says, hospitals in other states should be grateful their Florida peers took some the heat.

For example, under the demonstration project, CMS started out with an auditable "lookback" period of four years past the paid claim day, but based on feedback from the demonstration, revised it to three years, with a maximum look-back date of Oct. 1, 2007. Not too shabby.

The demo period also convinced CMS to limit the amount of information the RACs could demand without a specific reason. RACs won't be able to conduct automated or complex medical reviews of more than 10 records without specific CMS approval, and what's more, there's a limit on the volume of records RACs can request per 45-day period.

That being said, Reuben notes, "hospitals certainly need to take the program very seriously and prepare for national implementation." Mr. Reuben, rest assured, there's little doubt FierceHealthFinance readers will take your advice.

Related Articles:
House Dems request RAC program audit
RAC process heats up with complex validation audits
Preparing for the 'big RAC attack'

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