RAC Program ‘Devastating,’ Gorski Says

AAHomecare‘s Walt Gorski, vice
president of government affairs, spoke Friday at the National Medicare RAC
Summit, a conference about the new Medicare Recovery Audit Contractor
program. Under the program, the RACs will be paid a contingency
fee based on the amount of the improper payments they ferret out
and collect. After a three-year demonstration in six states found
more than $900 million in overpayments, CMS has implemented
permanent RACs, and the post-payment review program will roll out
to all 50 states by Jan. 1, 2010.

“RACs are a duplication of efforts currently on the books,
including CERT, OIG CERT, pre-pay PSC, NSC site inspections and
other programs,” Gorski said. “This program 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.”