California Hospital Files First Lawsuit Challenging a Recovery Audit Contractor Reopening

Posted by Jason Greis on May 11, 2009 under Articles | Be the First to Comment

A California hospital recently challenged the decision of a Medicare recovery audit contractor (RAC), alleging that the RAC unlawfully reopened claims submitted by the hospital. Palomar Medical Center v. Johnson, S.D. Cal., No. 3:09-cv-00605-BEN-NLS (S.D. Cal. complaint filed 3/24/09). The case is the first since the inception of the Medicare RAC program to challenge the ability of RACs to reopen Medicare claims more than one year after payment, and its outcome will significantly affect the ability of hospitals to generally treat Medicare payments as final a year after receipt. Read More...