Medicare Audits Go Nationwide this Fall
The Centers for Medicare & Medicaid Services (CMS) will be expanding the Medicare Recovery Audit Contractor (RAC) program - initially a pilot project designed to identify fraud and waste in the Medicare system - to all 50 states by the end of the year. CMS has said that California physician services will not be targeted for audits until October, even though the California RAC program will be officially rolled out on August 9. Audit contractors are expected to focus on providers whose Medicare charges are higher than the majority of providers in the community. Auditors are limited to requesting no more than 10 patient records from a practice in any 45-day period.
CMA is working closely with AMA to ensure that the program is not overly burdensome for physicians, and will be developing a toolkit to help physicians understand the program and, if necessary, navigate the audit process. Please contact the ACCMA at 510-654-5383 for additional information or assistance.
News
- CalOSHA ATD Regulations
- CMA has released a new "On-Call" document to help physicians understand new CalOSHA standards that require employers in health care settings to protect employees from aerosol transmissible diseases.
- Medi-Cal Payments on Hold
- While most physicians continue to be paid for Medi-Cal claims, some Medi-Cal payments are being held up while the California Legislature negotiates a new State budget.
- PECOS Enrollment Update
- To ensure adequate time to process applications before the January 3, 2011. Medicare is strongly encouraging physicians who are not currently enrolled in PECOS to initiate Medicare enrollment.
- MBC Notice to Consumers
- California physicians are now required to provide a "Notice to Consumers" to notify patients that they are licensed and regulated by the Medical Board of California (MBC). Find resources to comply.