Medicare RAC Audits Are Spreading in 2016

By now, however unwanted, health care providers are intimately acquainted with RAC audits. If you are one of the lucky providers who has not had the pleasure of undergoing a RAC audit and accept Medicare/caid, then you should go buy lottery tickets.

For Medicare providers, the RAC audits have been targeted to only Parts A and B. However, the Center for Medicare and Medicaid Services (CMS) proposes to expand the RAC audits to Medicare Advantage. CMS has published the proposal and seeks comments by February 1, 2016.

I am reminded of the Bubonic Plague from the 14th century.

As these Medicare audits continue to spread nationwide, to more CPT codes, and to more health care services, providers are warned to wash your hands. It is the best way to prevent acquiring a Medicare audit.

So far, there is no indication when the RAC audits for Medicare Advantage will begin. However, remember that RAC auditors are financially incentivized to audit and find errors. Thus, those RAC auditors will be chomping at the bit to get going.

Wouldn’t you if you were  compensated 9-13% of amount found to be owed back to the state?

More to come…

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on January 13, 2016, in Alleged Overpayment, CMS, CMS Proposal, CPT Codes, Doctors, Extrapolations, Federal Government, Federal Law, Health Care Providers and Services, Knicole Emanuel, Medicaid Attorney, Medicare, Medicare and Medicaid Provider Audits, Medicare Attorney, Medicare Audits, Medicare RAC, NC, North Carolina, Office of Medicare Hearings and Appeals, Physicians, Post-Payment Reviews, Program Integrity, RAC, RAC Audits, Regulatory Audits and tagged , , , , , , , , , , , , . Bookmark the permalink. 1 Comment.

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