CMS set to begin hospital RAC audits in 11 states

After seven months of delays, the Centers for Medicare & Medicaid Services announced it will begin its prepayment audits Aug. 27.

The Recovery Audit Prepayment Review demonstration projectallows Medicare Recovery Auditors (RACs) to review claims for Medicare compliance before they are paid.

The audits will focus on seven states with high populations of fraud and errors (Florida, California, Michigan, Texas, New York, Louisiana and Illinois) and four states with high volumes of short inpatient hospital stays (Pennsylvania, Ohio, North Carolina and Missouri).

CMS hopes the project will crack down on fraud and alleviate the “pay and chase” problem.

The three-year demonstration project was supposed to start in Jan., but was postponed twice.

Topics: Executive Leadership , Medicare/Medicaid , Regulatory Compliance