The Medicare recovery audit contractor (RAC) initiative is moving from pilot phase to national implementation, in stages. See my earlier post on the RAC initiative, the CMS report on RACs issued in February, other CMS materials on RACs, and also a recent article in which I’m quoted, in the April issue of Orthopaedic Practice Management — which appears in a slightly different form as the lead article in the May issue of Managed Care Contracting & Reimbursement Advisor.
OPM is a publication of Oakstone Medical Publishing; MCCRA is a publication of HCPro.
As I noted in the article, RACs focused on hospital claims during the demo phase (since that’s where the big bucks are) but now that the gloves are off, physician practices will feel the pinch more acutely. The CMS materials outline the rollout schedule for national implementation.
Bottom line: implementing a comprehensive compliance plan will go a long way towards avoiding having to deal with the RACs.