Tag: National RAC

LIVERMORE, Calif. - Performant Recovery was officially up and running as of March 8, but the new national RAC for HME is taking its time ramping up its activities.Peformant posted seven new reviews for everything from chest wall oscillation devices to complex Group 2 support surfaces in February. But it had not posted any additional reviews as of late March.“I would expect that they would add one or two edits every seven days to staff up to where they were at previously with known issues,”...

LIVERMORE, Calif. - Performant Recovery, the new national recovery audit contractor for DMEPOS and home health/hospice, announced March 8 that it has officially received approval from CMS to begin audit activity. The RAC in February posted seven new reviews on its workload page: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance...

WASHINGTON - CMS has tapped Performant Recovery to perform post-payment reviews of Medicare claims for DMEPOS and home health/hospice nationwide. The other RACs awarded contracts will perform post-payment reviews to identify and correct Medicare claims that contain improper payments that were made under Part A and Part B for all provider types other than DMEPOS. Performant Recovery also won that contract for Region 1. Cotiviti won contracts for Region 2 and 3, and HMS Federal Solutions won a contract...

YARMOUTH, Maine - A tug of war between CMS and the RACs over planned changes to contingency fees could lead to a new national RAC for HME, says Andrea Stark.As part of its latest requests for proposals, CMS announced plans to implement a number of changes to its RAC program and one, in particular, has driven two contractors to file protests: The agency wants to prevent the RACs from collecting contingency fees until the second level of appeals is exhausted.“CMS has paid out beaucoup dollars,”...

WASHINGTON - A sweeping new program to identify overpayments specifically for DME, home health and hospice is underway.CMS announced on Dec. 30, amid the quiet of the holidays, that it selected Connolly as the recovery audit contractor (RAC) to oversee the national program.“The announcement came a lot earlier than I thought,” said Wayne van Halem, president of the van Halem Group. “I thought we'd have until mid-2015.”Wilton, Conn.-based Connolly is already the RAC for Jurisdiction...