Congressman urges HHS to modify RAC program

AHA News Now

Rep. Jim McDermott (D-WA), ranking member of the House Ways and Means Health Subcommittee, yesterday urged the Department of Health and Human Services to require enhanced accountability for Medicare recovery audit contractors rather than implement its two-midnight policy for inpatient admissions and medical review criteria. “I continue to have serious reservations about this policy and believe that it will only exacerbate the appeals backlog,” he said in a letter to HHS Secretary Kathleen Sebelius. He added, “I suggest that there needs to be some financial penalty associated with RA collections that are overturned on appeal. If providers are winning these appeals by large margins, which seems to be the case, this seems only fair…I also suggest that going forward, the contracts include performance standards for accuracy of collections from providers.” AHA supports the Medicare Audit Improvement Act (H.R. 1250/S. 1012), a comprehensive bill for reforming the RAC program. The bill currently has 202 cosponsors in the House and 11 in the Senate. AHA also supports the Two-Midnight Rule Coordination and Improvement Act (S. 2082), legislation that would require CMS to implement a new payment methodology for short inpatient stays in FY 2015, and the Two-Midnight Rule Delay Act (H.R. 3698).

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