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Take a look at this summary report from the CMS. It will open in a new window. Basically from Oct 2009 to Mar 2011 the RACs have recovered $365.8M. Of that over half was collected from Jan 2011 to Mar 2011. Things are speeding up. There has been, and still is, a learning curve going [...]
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Continue ReadingBrace yourself and get ready for a rough ride. For over a year now, whenever the subject of medical necessity has been raised, the standard response from CMS has been “medical necessity is not being reviewed at the present time”, or close variations thereof. “At the present time” gave goosebumps to those who follow the RAC auditing program closely. The other shoe would fall, we just didn’t know when.
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Continue ReadingAs mentioned before, it is not in the interest of the RAC’s to report a physician for fraud. Why? The RAC’s get ZERO if they report for fraud…BUT if they retract funds paid to a Doc, they then get a percentage of that take. Make sense? How about this: As report in USA Today on [...]
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