DecisionHealth, DecisionHealth - 2009 Issue 9 (September)

CMS: RACs can't override LCDs unless decision is in your favor

Your Recovery Audit Contractor (RAC) can't disregard the coverage conditions in your local coverage determinations (LCDs) to demand overpayments on any claim in a complex review, CMS officials say. If a RAC believes you should've been paid for a service despite a relevant LCD saying otherwise, it has the power to override the LCD and approve the claim,

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