Tag Archives: RAC

GAO Releases Report Critical of CMS Contractor Process

Earlier this week, the Government Accountability Office (GAO) released a report entitled “Increasing Consistency of Contractor Requirements May Improve Administrative Efficiency.”  Members of Congress pressed GAO to look at issues that have arisen about the efficacy of claim reviews by … Continue reading

Posted in Orthotics and Prosthetics, re provider, Regulatory, Uncategorized | Tagged , , , , , , | Leave a comment

Update: CMS Says Letter Outlining O&P Audit Limits Incorrect

Last week, OPGA heard from several members detailing a letter they had received which rescinded documentation requests on certain orthotic and prosthetic claims prior to 2011. Details were scant, but we wanted to get the information in the hands of … Continue reading

Posted in Orthotics and Prosthetics, Prosthetist, re provider | Tagged , , , | Leave a comment

UPDATED: Report: CMS Rescinds RAC Audits on Claims Prior to 2011

UPDATE: CMS says auditors improperly sent letters out on orthotic and prosthetic claims. Only audits on power mobility devices have been limited to a twelve month look back period. This was necessitated by the prior authorization project for PMD’s which began … Continue reading

Posted in Orthotics and Prosthetics, Prosthetist, re provider | Tagged , , , , , | Leave a comment

How to stop CMS from taking your $$

I wanted to pass along this great post from Linda Collins and the Ossur Regulatory blog. Linda describes how an independent O&P can stop CMS from withholding/requesting overpayments until much later in the appeals process by being organized and replying … Continue reading

Posted in Orthotics and Prosthetics, Prosthetist, re provider | Tagged , , , , , | Leave a comment

CMS to Create New National RAC for DMEPOS, Home Health

CMS recently announced their intent to create a fifth Recovery Audit Contractor (RAC), in addition to the four current regional RAC’s. This new national contract would be awarded specifically for identifying improper payments for home health, hospice claims and payments for … Continue reading

Posted in Orthotics and Prosthetics, Prosthetist, re provider | Tagged , , , , | Leave a comment

OPGA Launches Speak4OandP, Calls for Independent Practitioner Action

Are you tired of being audited on seemingly all prosthetic claims for Medicare beneficiaries? Now is the time to stand up for independent orthotic and prosthetic practitioners and facilities. Orthotic and Prosthetic Group of America (OPGA) recently launched Speak4Oandp.com, a … Continue reading

Posted in Orthotics and Prosthetics, Patient, Prosthetist, re provider | Tagged , , , , , , , | Leave a comment

OIG: ALJ’s Overturn 56% of Provider Generated Appeals to QIC Audits

The HHS Office of Inspector General earlier this month released a report which studied the shockingly high overturn rate of provider generated appeals to private contract auditors employed by CMS to the Administrative Law Judge level.  The OIG found that 56% … Continue reading

Posted in Manufacturer, Orthotics and Prosthetics, Prosthetist, re provider, Regulatory | Tagged , , , , , , , | Leave a comment