Citing problems with its implementation--a fancy way of saying that many providers feel they've been unfairly hassled or even ripped off--two House leaders have asked the Government Accountability Office to mount a study of of Medicare's Recovery Audit Contractor program. House Energy and Commerce Committee Chairman John Dingell (D-MI) and Ways and Means Committee Chairman Charles Rangel (D-NY) want the GAO to review the RAC program before it goes from demonstration project to permanent status later this summer.
In their letter to the GAO, the two are asking the GAO to investigate a range of problems cited by critics. This includes loud complaints by inpatient rehab facilities in California, who say that RACs communicated inconsistently, used unqualified personnel and didn't follow Medicare policies when conducting reviews. Providers have argued that the RAC program's use of contingency fees was inherently prone to abuse, particularly given that it lets RACs keep their fee if their collections survive the first level of appeal, regardless of whether they were ultimately found to be correct.
After the GAO completes its investigation, Reps. Dingell and Rangel are asking it to make recommendations for how to improve the RAC program in light of lessons learned from its pilot phase, including ideas on how CMS can oversee RAC contractors and coordinate their work with other Medicare contractors.
To find out more about the requested investigation:
- read this HFMA News item
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