AMA Calls for Massive Overhaul of RAC Program

In a letter addressed to CMS administrator Marilyn Tavenner, James Madara, MD, the executive vice president and CEO of AMA calls for CMS to act on the two-year backlog of Medicare and Medicaid appeals. “The AMA does not support improper billing, but the Recovery Audit Contractor (RAC) auditors are often wrong and their bounty-hunter like tactics have caused physician practices undue hardship and expense,” said AMA President Robert Wah, MD. “As CMS awards new contracts in the RAC program, it must consider putting an end to policies that cause burdens for physicians and encourage RAC auditors to incorrectly deny claims.” There was a 506 percent increase in appealed claims between 2012 and 2013, causing a significant backlog. Wah added that the appeals process is an additional burden facing physicians who are already struggling to meet a growing list of regulatory requirements.