RACMonitor

With a stroke of pen, President Obama last Friday signed into law the "Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010," which among other provisions, clarifies Medicare's policy for payment of services provided in hospital outpatient departments on either the day of or during the three days prior to an inpatient admission (known as the 3-day payment window).

The Centers for Medicare & Medicaid Services modified its FY2010 Additional Documentation Request (ADR) Limits, expanding the scope of the rule to include all institutional providers.

Health Data Insights has posted 66 new approved issues for review on their Web site. HDI is the CMS Recovery Audit Contractor (RAC) for several states in the western U.S.

There's a new auditor in town, and its mission is to focus on the Medicaid program - just like recovery audit contractors (RACs) focus on the Medicare program.

Florida outpatient therapy providers report receiving Demand Letters under the Recovery Audit Contractor Program from Connolly, the Region C RAC.

DCS, the Recovery Audit Contractor for Region A, has posted its first CMS approved issues to its Web site.

In a somewhat surprise move Wednesday afternoon Connolly Healthcare, the Region C RAC, posted a new CMS approved issue regarding clinical social work services.

Though you may consider the RACs to be like bounty hunters, the RACs are certainly NOT pirates - CMS will be holding them to the same rules that apply to current reimbursement administrators, carriers, Fiscal Intermediaries (FIs) and Medicare Administrative Contractors (MACs).