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November 26, 2007
Urge Your U.S. Rep. to Cosponsor HR 4105
DELAY IMPLEMENTATION OF RAC PROGRAM
Action:
Please contact your U.S. Representative immediately and urge him/her
to co-sponsor H.R. 4105, IHA backed legislation that will place a one-year
moratorium on the Centers for Medicare & Medicaid Services’ (CMS) Medicare
Recovery Audit Contractor (RAC) Program.
Click here to send an e-mail to your Representative.
Introduced by Reps. Lois Capps (D-CA) and Devin Nunes (R-CA), H.R. 4105
would:
- Place a one-year moratorium on the CMS’ Medicare RAC program.
- Direct CMS to provide Congress with a detailed program status report.
- Charge the Government Accountability Office (GAO) with investigating the
accuracy and efficiency of RACs and finding out if they are in compliance with
Medicare policy regarding denials and appeals.
Background:
The Medicare Recovery Audit Contractor (RAC) Program was authorized by
Congress to identify improper Medicare payments, including both overpayments and
underpayments. Paid on a contingency basis, RACs receive a percentage of the
improper payments they identify and collect. CMS currently operates the RAC
program in five states, California, Florida, Massachusetts, New York and South
Carolina, and plans to expand the program nationwide by 2010. Illinois presently
is scheduled for 2009 enrollment.
Despite CMS’ recent release of a revised "statement of work" that delays
implementation for some hospitals in some states, the agency is scheduled to
begin program expansion in March 2008 – before correcting several
critical problems identified during the demonstration project.
Delaying implementation of the program, as called for by H.R. 4105, would
give CMS time to address key problems with RACs by developing more appropriate
payment incentives, providing greater oversight, and increasing transparency of
RAC processes.
Urge your U.S. Rep. to cosponsor H.R. 4105 and delay CMS
implementation of the Recovery Audit Contractor Program
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