Posted by Jason Greis on May 11, 2009 under Articles | 
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...
Tags: alj, greisguide, greisguidetoltachs, hospital, ltac, LTACH, LTCH, mac, mcguirewoods, medicare, palomar, PRG-Schultz, RAC, recovery audit contractor
Posted by Jason Greis on March 4, 2009 under Articles, Whitepapers |
Success of the RAC Demonstration Project in Recouping Overpayments to Medicare Providers Leads to National Program Expansion. Read More...
Tags: audit, automated review, CGI Technologies and Solutions, complex review, Connolly Consulting, Data Warehouse, demonstration project, Diversified Collection Services, greisguide, greisguidetoltachs, HealthDataInsights, hospital, james b. riley, jason greis, jim riley, ltac, LTACH, LTCH, Medicaid, medicare, prepare, PRG-Schultz, RAC, recovery audit contractor, Viant
Posted by Jason Greis on February 17, 2009 under Articles |
On February 14, 2009 my colleague, Elissa Moore, posted the following informative update on the North Carolin Healthcare Report weblog, of which she is a co-Author. The posting describes the resumed rollout of CMS’s recovery audit contractor (RAC) program and further details of the RAC program. Elissa, Brent Rawlings, and I (together with members of Marsh Risk Consulting’s Global Clinical HealthCare Consulting Team) will be discussing the impact of RAC audits on post-acute and acute care providers during a complimentary 1-hour webinar on March 3, 2009. Please click here for additional information and to register for the webinar. Read More...
Tags: bid protest, CGI, cms, Diversified Collection Services, elissa moore, HealthDataInsights, hospital, Inc., ltac, LTACH, LTCH, North Carolin Healthcare Report, PRG-Schultz, RAC, recovery audit contractor, subcontractor, Viant Payment Systems
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