PPAC Worried about RACs

HME providers aren’t the only ones worried about CMS’ new
Recovery Audit Contractors. At a meeting March 9, members of the
Practicing Physicians
Advisory Council ticked off a number of concerns about the new
RACs — most notably that the contractors are paid a
contingency fee to identify improper payments. In addition,
according to the docs, just getting medical records to the RACs
will be a burden. In a letter addressed to CMS Acting Administrator
Charlene Frizzera, the physician groups urged CMS to limit medical
record requests to three in a 45-day period for solo practitioners.
In addition, the letter said, the physician organizations “continue
to believe that the RAC program is not the appropriate vehicle for
achieving payment accuracy and will continue to advocate for its
elimination and the redirection of incentive payments to physician
outreach and education.”

HME providers have questioned CMS’ payment method for the RACs
since a three-year demonstration began in 2005. And following a
March 6 conference on the audit program, AAHomecare’s Walt Gorski,
vice president of government affairs, said it will have a “devastating
impact on home care providers because we will be held
responsible for what is in the medical record. AAHomecare believes
there is a need for a new approach to stopping improper payments,
focusing on better screening on the front end and denying entry
into the Medicare program for entities that should not receive NPI
numbers to begin with.”

Following the RAC demonstration, which covered six states, CMS
is set to roll the program out nationwide in 2010. For more, see
RACs
Ready to Rack Up Improper Payments, HomeCare Monday,
Nov. 17, 2008.