Centers for Medicare & Medicaid Services (CMS) officials say the Recovery Audit Contractor (RAC) program will resume after the agency resolved a protest that delayed its attempt to recoup improper Medicare payments to physicians and health care professionals.
CMS put the RAC program on hold last fall when two unsuccessful bidders to become audit contractors filed a protest with the Government Accountability Office. The agency says the dispute was settled when the two companies agreed to become subcontractors.
CMS has not said when the RACs will begin operating in Texas, but TMA officials are worried that Texas physician practices could suffer serious financial problems when they do.
As the March issue of Texas Medicine will report, hospital and state medical society officials in states where the program was pilot-tested say the RACs created massive paperwork nightmares for physicians and other health care professionals and took a huge bite out of hospital and physician practice revenues. An additional concern is that the audit contractors likely will be nothing more than bounty hunters looking to turn a fast buck.
"We're very alarmed about this," Houston ophthalmologist Keith Bourgeois, MD, chair of TMA's Council on Socioeconomics, told Texas Medicine . "The thing physicians need to understand is that the way the RACs work is they get a percentage of the funds they recover. So there is a huge incentive for them to recover as much as they can and very little incentive for them to identify underpayments to physicians."
Action , Feb. 16, 2009
Last Updated On
June 03, 2016