Washington, DC (PRWEB) January 15, 2015
Despite having their contracts extended through the end of the year, the four existing recovery audit contractors (RACs) will not review inpatient admissions in terms of whether patients were appropriately admitted or should have been treated as outpatients, a CMS spokesman tells Atlantic Information Services, Inc.’s (AIS) Report on Medicare Compliance (RMC) in its Jan. 12 issue. Inpatient hospital patient status reviews will presumably resume next year, when the second round of RAC contracts takes effect.
For 2015, the incumbent RACs will do automated reviews, though some will be complex, involving the review of medical records submitted by hospitals, RMC has learned. They are also conducting limited reviews of spinal fusion, cosmetic surgery, outpatient therapy, durable medical equipment and other risk areas approved by the agency. The four RACs will continue to work on appeals and reconciliations through April 2017, says Emily Evans, a partner in Obsidian Research in Nashville.
When the new RAC contracts are awarded next year, patient status and inpatient rehabilitation will be probable targets, Atlanta-based attorney Sarah Kay Wheeler of King & Spalding tells RMC, citing “a lot of activity prior to the expiration of contracts in inpatient rehabilitation.”
Visit http://aishealth.com/archive/rmc011215-01 to read the article in its entirety.
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