RAC Audits for Anesthesiologist Overpayments


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Topic RAC Audits for Anesthesiologist Overpayments
Background Anesthesia provided by an anesthesiologist and a CRNA (Certified Registered Nurse Anesthetist) without a 50% cutback as required by Medicare guidelines involving anesthesiologists supervising CRNAs. Connolly is the designated contractor for RAC audits in Texas. CMS oversees the program. Claims dating back to October 2007 are subject to possible audit.
Regulating Body CMS - Connolly
Compliance Date 9/6/2011
Consequences If audited, records may have to be provided to Connolly and the practice may be required to appeal any alleged discrepancies.
Next Steps Review past billing (from 2007 onward) and self audit to determine compliance. Visit texmed.org/practicehelp for TMA consulting.
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