GAO supports delay in RAC fees

Thursday, May 1, 2014

WASHINGTON – The Government Accountability Office (GAO) this week signed off on Medicare’s plan to pay RACs for audits of hospitals only if a second-level appeals judge upholds their findings, according to news reports. The change is one of several that CMS plans to put in place as part of signing on a new group of RACs in 2014. “At this point, I do not think that the change will impact how much the RACs get paid, since appeals to the first and second levels are almost always decided in favor of the RAC/CMS,” Emily Evans, a partner and analyst at Obsidian Research Group, told Modern Healthcare. RACs receive between 9% and 13% of payment amounts flagged as inappropriate.