CMS Administrator Touts Changes to RAC Program

Administrator Seema Verma recently highlighted changes to the Recovery Audit Program that are intended to make the program more provider friendly. Recovery Audit Contractors (RACs) review payments made to healthcare providers under Medicare Fee-for-Service plans. CMS will be providing better oversight of RACs in several ways, including by requiring RACs to have a 95% accuracy score. RACs also will be required to maintain an overturn-on-appeal rate of less than 10%. If a RAC fails to achieve either metric, the CMS will progressively reduce the number of claims the RAC can review.

Source: https://www.jdsupra.com/legalnews/cms-administrator-touts-changes-to-rac-35512/