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RACs Are Back, At Least Through 2015
The 4 private companies that run Medicare's recovery audit program will have their contracts extended through 2015. But it's unclear what types of medical reviews or claims are going to be eligible for auditing.
The 4 private companies that run Medicare's recovery audit program will have their contracts extended through 2015. But it's unclear what types of medical reviews or claims are going to be eligible for auditing.
CGI Federal, Connolly, HealthDataInsights, and Performant Recovery will be able to actively audit hospitals, doctors and other providers for improper Medicare payments through December 31, 2015, CMS said in a contract award notice posted December 24. Additionally, the recovery audit contractors, or RACs, will be allowed to perform administrative and transitional activities through April 30, 2017. That year-and-a-half period allows them to review any last-minute claims and manage the appeals process.
Read more at Modern Healthcare: http://bit.ly/1Bqwre0
Trump Administration’s Message to Supreme Court Puts New Wrinkle in Braidwood Case
February 21st 2025The Trump administration argues that HHS Secretary Robert F. Kennedy Jr can overrule the US Preventive Services Task Force to determine the preventive services covered under the Affordable Care Act.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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5 Key Health Care Moments During President Trump's First Month Back in Office
February 21st 2025President Donald J. Trump pushed for significant health care changes during his first month back in office, through executive orders affecting managed care, drug pricing, and clinical trial diversity guidance.
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Same-Day Breast Imaging Gaps Reveal Health Care Disparities
February 18th 2025For this retrospective study, the authors examined data on more than 3 million screening mammographies for more than 1 million female patients; of the screenings, 23.6% had abnormal results and only 6.7% were recommended for biopsy.
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