In brief: Providers win RAC audits, 'doc fix' reappears on radar screen

Thursday, July 1, 2010

WASHINGTON - The majority of providers who have appealed Recovery Audit Contractor (RAC) audits have won, according to a new report. In "The Medicare Recovery Audit Contractor Program: Update to the Evaluation of the 3-year Demonstration," CMS reports that 76,073 providers (12.7%) chose to appeal RAC audits from the inception of the program through March 9, 2010, and 48,993 providers won (64.4%). In all, the RAC found 598,238 claims with overpayment determinations through March 9, 2010. To read the report in full, go to

Competitive bidding: 'Doc fix' reappears on radar screen, letter makes the rounds

WASHINGTON - Congress has approved a "doc fix" bill that delays a 21% reimbursement cut to physicians until November, opening the door for what will likely be another bill later this year that could serve as a potential vehicle for eliminating competitive bidding. At press time, H.R. 3790, the industry's bill to eliminate competitive bidding, had 253 co-sponsors. Stakeholders encourage providers to contact their representatives and senators about H.R. 3790 while they're on recess July 2 to July 12 ... In other news, a letter that stakeholders hope will spark support for H.R. 3790 is making the rounds. Co-signers so far include the ALS Association, the United Spinal Association and various state associations. The deadline for signing: July 8. For more info, e-mail Alex Bennewith at

AHP 'moves' to Nevada

BRENTWOOD, Tenn. - American HomePatient has reincorporated the company from Delaware to Nevada, through a merger agreement. There will be no change in the company name, headquarters, business, jobs, management, location of offices or facilities, number of employees, assets, liabilities or net worth, the company stated in release. AHP operates in 33 states.

Auditor mistake leads to claim denials

NASHVILLE, Tenn. - An error by a ZPIC contractor has led to erroneous denials of 48,000 claims in Jurisdiction C, according to a bulletin sent out last week by the National Association of Independent Medical Equipment Suppliers (NAIMES). THE CO-184 denial states that the "prescribing/ordering provider is not eligible to prescribe/order the service billed." Cigna Government Services, the DME MAC for Jurisdiction C, has corrected the edit and will reprocess all claims that were affected.

Get ready to lobby

ALEXANDRIA, Va. - AAHomecare has scheduled its 2011 Washington Legislative Conference for March 16 and 17 at the Westin Washington, D.C., City Center Hotel. Stay tuned for further details.