Topic: Recovery Audit Contractors
CMS has failed to recover more than half of the nearly $3 billion in Medicaid overpayments identified by auditors over an 11-year period.
Recovery audit contractors (RACs) returned $214 million to the Medicare program in fiscal year 2016.
Goodrich told attendees at a recent listening session that "2018 is going to be a significant year in terms of regulatory and burden reduction."
From Kaiser Health News: The government never recouped most of the $128 million in overpayments it was owed from Medicare Advantage plans.
The Centers for Medicare & Medicaid Services is offering to pay a portion of denied claims to hospitals that drop coverage appeals in hopes of clearing a backlog of suits.
Hospitals are still enjoying success at appealing RACs, although the process is still backlogged.
CMS has resumed payment reviews for Beneficiary and Family Centered Care Quality Improvement Organizations.
The American Hospital Association isn't pleased with a federal proposal to streamline the amount of time it takes to appeal claims denials in administrative law courts.
From Kaiser Health News: A year after paying nearly $1.5 billion to more than a third of U.S. hospitals to resolve longstanding Medicare billing disputes, the Obama administration has disclosed who got paid.
CMS did not offer Prime Healthcare Services the same deal other hospitals got to settle disputed short-stay claims.