BC Advantage - 2011 Issue 10

Beware of RACs Bearing Gifts

In this edition of IMA Insights we discuss the increasing effect of the Recovery Audit Contractors (RAC) on hospitals Transfer DRG cases. There has been a significant increase in activity where RACs are identifying what are believed to be underpayments to hospitals. This article will explore the potential compliance issues that may arise as a result of these RAC findings. BackgroundAs initially enacted by Congress and implemented by The Centers for Medicare and Medicaid Services (CMS), the scope of the transfer payment policy was relatively narrow. Effective for discharges that occurred on or after October 1, 1998, CMS...

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