AHA RAC Advocacy Resources

 

CMS Updates RAC Demonstration Report.  In January 5, 2009 CMS issued a second update to its July 2008 RAC report, which includes appeals data through August 31, 2008.  The report can be found at: www.cms.hhs.gov/rac.

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Action Alerts and Special Bulletins

Special Bulletin: Medicare Recovery Audit Contractor Program – Back on Track, 02/11/09 Members Only
CMS is taking steps to resume its rollout of the permanent RAC program.  This bulletin describes CMS’s next steps in implementing the permanent RAC program.

CMS Releases New RAC Demonstration Report, 07/11/08 - New RAC Demonstration Report, which provides the most complete overview to date of the demonstration program and improvements CMS has planned for the permanent program.

Special Bulletin: CMS Actions May Affect RAC Demo Hospitals, 06/05/08 Members Only 
This bulletin for the 5 demonstration states describes how CMS will handle appeals for "good cause" and other inappropriate denials.  

Special Bulletin: New Guidance Improves Appeals Process for Medicare RAC Denials, 02/27/08 Members Only  
This special bulletin describes a few of the AHA-recommended improvements to the Medicare RAC Appeals process included in the February 27, 2008 CMS transmittal to Medicare contractors.

Advisories

Member Advisory: Medicare Recovery Audit Contractors (RACs): Permanent Program Basics, 04/20/09 Members Only
This advisory aims to provide an overview of the permanent RAC program. It describes the guidelines RACs must follow, the requirements for hospitals and the timeline for the national rollout of the program.

Regulatory Advisory: The Medicare Appeals Process, 03/27/09 Members Only
The attached advisory reviews the Medicare appeals process, including recent changes, and the distinct protocols for appealing payments denied by RACs.

Regulatory Advisory: Recovery Audit Contractors (RACs): Coding & Documentation Strategies, 07/16/08 Members Only
This advisory highlights the types of coding issues targeted during the RAC demonstration and
strategies your organization can implement to reduce the impact of RAC audits.

Member Advisory: Recovery Audit Contractors (RACs): Preparing for RAC Audits, 03/03/08  Members Only 
This advisory highlights the types of inpatient claims that were targeted during the RAC demonstration and some strategies and tools your organization can implement to minimize the impact of future RAC audits.

RAC Report

RAC Report: Recovery Audit Contractor Program Update, 05/28/09 Members Only

Comment Letters

Sample Letter Supporting the Medicare RAC Moratorium Act of 2007 (H.R. 4105),  02/22/08 Members Only
This letter to Members of Congress expresses support for HR 4105 and asks for congressional co-sponsors.

AHA, CHA, HANYS Letter to Reps. Rangel, Stark, Capps and Nunes Regarding Recovery Audit Contractor (RAC) Demonstration Project, 12/10/07 
This joint letter to key Congressional officials expresses continued concern about issues with the November 7, 2007 revised CMS Statement of Work.

RAC Comment Letter to CMS on Proposed Statement of Work in the Request for Proposal on CMS’ national implementation of RAC program, 10/26/07 

RAC Statement of Work Technical Comments, 10/29/07
This document serves as an addendum to the American Hospital Association’s October 26 comment letter to CMS on the RAC program.

Testimony

Testimony: Improving the Paperwork Reduction Act for Small Businesses,  02/28/08 
This testimony was presented by Linda Brady, M.D., president and CEO of Kingsbrook Jewish Medical Center, Brooklyn, NY about how laws and regulations, combined with the very complex health care payment system,  is  making the already difficult task of operating on the front lines of American health care more challenging than it should be.