Medicare
RAC Cloud
Appealing Medicare Claims Determinations
This resource provides an overview of the Medicare Part A and Part B administrative appeals process available to beneficiaries, providers, physicians and other suppliers who provide services and suppl
On Dec. 8, CMS published in the Federal Register a proposed rule that would make changes to the Medicare Shared Savings Program for accountable care organizations.
The AHA recommends that the Centers for Medicare & Medicaid Services (CMS) require greater transparency in how states set MCO capitation rates.
Fundamental reform of the RAC process is at the heart of an effective and permanent solution to the appeal backlog problem and will enable hospitals to get timely administrative review that clearly is required by the Medicare statute.
CMS published in the Nov. 13 Federal Register the final rule for calendar year (CY) 2015 with changes to the Medicare physician fee schedule (PFS) and other revisions under Medicare Part B. Without additional congressional action, CMS estimates that Medicare physician payments will decline by a…
We are truly dismayed to see that despite the numerous legal defects that we identified in these audits, the OIG has proceeded to issue at least four new audit reports using extrapolation in the last month that include many of the same flaws.