Ernie De Los Santos

Following the lead of Connolly Healthcare, CGI, the RAC for CMS Region B, has posted an approved issue to review Inpatient Admission Orders.

The Recovery Audit Contractor for Medicare's Region B, CGI Federal, late Wednesday posted 87 new DRG Validations in 10 approved issues, capping a 10-day period that witnessed a total of 126 new DRG Validations and new patient E & M codes from all four RACs.

During the May 5, 2010 RAC 101 Conference Call, Scott Wakefield, a CMS RAC Project Manager for Region B stated that providers may begin to receive RAC medical necessity reviews "within the next month or so."

Analysis of the newly posted issues from Connolly Healthcare and Health Data Insights reveals that for first time Rehabilitation Facilities and Physician Practices are now more heavily targeted than before.

Connolly Healthcare, the RAC for Region C, has posted 19 new approved issues for Complex Review on their RAC Issues page.

Get your RAC teams ready now, because the medical record requests alone can bury you. That's the message I took from the Healthcare Financial Management Association's ANI conference in Seattle.

The Centers for Medicare and Medicaid Services (CMS) has cancelled four RAC Outreach Sessions scheduled for Texas in May over concerns about the H1-N1 flu virus.

There is a common fear among rural providers that communities will wind up losing their local hospitals because CMS will bankrupt them, not based upon fraud and abuse, but rather based upon what the physicians do or do not put into their documentation, which the facilities have no way to control.