Tag Archives: RAC

“Finally Friday!” RAC Actions: Fall 2017

Friday, September 15 2017 RAC Actions: Fall 2017 …Or… WHAT can they do, WHEN can they do it, and HOW? Watch for the Handouts As providers well know, these “killers” can sneak up on you! Finally Friday! Broadcasts are Sponsored … Continue reading

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“Finally Friday!” The Prodigal RAC Returns

FRIDAY February 17, 2017: The Prodigal RAC Returns or Rules? Nah… Rules are so 2016… Watch for the Handouts Finally Friday! Broadcasts are Sponsored by The Health Law Partners, ZirMed, and The American College of Physician Advisors THIS WEEK, we … Continue reading

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“Finally Friday!” Hospital Appeals Settlements and OIG Work Plan Woes

FRIDAY November 11, 2016: “Hospital Appeals Settlements and OIG Work Plan Woes” or How The Appeals Settlement reminds me of the $5 scam from the movie “Paper Moon” Get the Handouts Sponsored by The Health Law Partners, MAS Coding Solutions … Continue reading

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Hospitals still confronting RAC backlogs

According to the most recent data from the American Hospital Association’s RACTrac Survey of 676 hospitals nationwide, 45 percent of denials were appealed through the second quarter of 2016, with 56 percent of those appeals related to inpatient coding den Continue reading

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Federal court denies HHS request for delay in Medicare appeals backlog case

A DC federal court trial judge today denied the government’s request to delay further proceedings in a case brought by the AHA and three hospital organizations to compel the Department of Health and Human Services to meet its congressionally mandated dead Continue reading

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CMS Keeps But “Adjusts” Two-Midnight Rule

CMS proposes that physicians be allowed to make case-by-case exceptions to the rule, classifying certain short stays as inpatient for reimbursement under Medicare Part A. Continue reading

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Infographic by AHA seeks RAC reforms

Check out other American Hospital Association infographics To post this on your own website, visit this page.

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SGR Fix Extends Moratorium on 2-Midnight Rule Enforcement

H.R.2 Restricts RAC Reviews of Patient Status Through September Passage of the bill H.R. 2 Medicare Access and CHIP Reauthorization Act (MACRA) last night by the U.S. Senate extended many programs, including a slight extension of the Medicare Administration Contractors … Continue reading

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“Finally Friday!” CMS OMHA Settlement Conferences and Statistical Sampling

OMHA Settlement Conferences and OMHA Statistical Sampling Alternate but Rejected Title for this Show: How CMS Plans to Use Your Money to Solve Their Problems We were joined this week by Jessica Gustafson and Abby Pendleton from The Health Law … Continue reading

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“Finally Friday!” MAC Probes, AHA Lawsuits, and OIG Reports on E/M

Bill Malm of Craneware reviews some new OIG Reports, foreshadowing perhaps a flood of E/M Audits by CMS contractors. We also hear from Dr. Ron Hirsch of Accretive PAS about some of the insanity coming out of the MACs in Probe and Educate. Jessica Gustafson and Abby Pendleton from The Health Law Partners give us some legal perspective on the OIG postings, and a short review of the recent AHA filing of a mandamus complaint – a filing seeking a judicial remedy to require CMS to “meet statutory deadlines for administrative review of denials” for Medicare claims. Continue reading

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