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Waste, Fraud, & Abuse News

CMS Awards Recovery Audit DME Contract

  FOR IMMEDIATE RELEASE December 31, 2014 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 CMS Awards Recovery Audit DME Contract Spotlight on the area that accounts for highest percentage of the CERT error rate Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) moved forward to award the first national recovery audit contract to identify […]

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Inside CMS: Spending Bill Bashes RACs, Hits CMS and OMHA Over Appeals Backlog

  Read more at Inside CMS (subscription required).

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Coalition: Omnibus Bill Too ‘Sympathetic’ to Industry Responsible for Billions in Medicare Waste

  FOR IMMEDIATE RELEASE: December 15, 2014 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Washington, D.C. – The American Coalition for Healthcare Claims Integrity (ACHCI) issued a statement today regarding provisions in the Omnibus spending package that pertain to Recovery Audit Contractors and improvements to the ALJ hearing backlog. “Our coalition is pleased to see language […]

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Wall Street Journal: Medicare Overbilling Probes Run Into Political Pressure

  Despite efforts to combat waste and abuse of taxpayer funds, providers use members of Congress to keep Medicare money coming. Read more at the Wall Street Journal

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ACHCI Recommendations for Improvements to Appeals Process

 

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Inside Health Policy: RACs Ask To Be More Involved In ALJ Appeals

  Recovery Audit contractors want to be more involved at the ALJ appeal level to help speed up the process and cut back the growing backlog of appeals. Read more at Inside Health Policy(subscription required).

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Wall Street Journal: New Medicare Rules Aim to Reduce Abuse

  The Obama administration has enabled the Centers for Medicare and Medicaid Services to take direct action to kick doctors out of the Medicare program for abusive billing practices. Read more at the Wall Street Journal(subscription required).

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RAC Facts: A Guide to Medicare Contractors

  Medicare is a massive federal program, with 50 million beneficiaries, and over a million providers, CMS can process up to 4.4 million claims and $1 billion on any given day. It takes a lot of work to ensure that everything works correctly. To ensure Medicare integrity, CMS employs a variety of contractors to review […]

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American Action Forum Release RAC Program Primer

  The American Action Forum, a Washington-based policy institute, released a primer today that provides a valuable introduction to the Recovery Audit program, the “Two-Midnight” rule, and the issues surrounding Medicare integrity. Read the primer on the here, at the AAF website.

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Medicare FFS Error Rate Continues To Increase In Fiscal 2014

  As the RAC moratorium continues, the Medicare fee-for-service error rate has climbed to the highest rate in history. Read more from Inside Health Policy: Read more at Inside Health Policy(subscription required).

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