Medicare
Medicare Recovery Audit Contractor (RAC) Information:
Password required to view RAC documents.
- Update on RAC Audits
CMS has updated its January 2009 report on Medicare's three-year RAC
demonstration program to include appeals information through March 9, 2010.
More information.
- Additional Insights on Recent ADRs from
CGI
CGI Technologies, Illinois' Medicare RAC, began its reviews of provider
medical records in January and sent letters to providers requesting
additional documentation for paid claims. More
information and link to the report.
- Initial Record Requests from CGI
To ensure providers receive information (medical records requests, requests
for payments, etc.) from the RAC on a timely basis, IHA and MCHC constructed
a list of RAC "liaisons" for each member hospital. This
memo follows up on CGI's
response to provider concerns that these requests are being directed to a
generic provider address versus the specific contact information that was
originally sent to CGI. More
information.
- New RAC Audit Issues for Illinois
The RAC is required to list CMS-approved audit issues on its web site prior
to initiating new reviews. This memo
lists additional automated review issues that CGI would be conducting.
More information.
- Notifying IHA/MCHC of RAC Demand
Letters
Upon determination of a provider overpayment, the Medicare RAC will notify
the provider via a demand letter as to the nature of the denial, along with
the overpayment amount. IHA or MCHC (or both) is requesting notification of
the letter when it is received. More
information.
- Medicare RAC
Region B Web Site
General Information: Password required to view comment
letter.
- Comment Letter: CMS1504-P; Proposed Changes to the Hospital
Outpatient PPS and CY 2011 Payment Rates (8/31/10)
IHA Comments on CMS' hospital outpatient and ambulatory surgery prospective
payment system proposed rule for fiscal year 2011.
More information.
- Comment Letter: CMS 1498-P;
Proposed Changes to Hospital Inpatient PPS for Acute Care Hospitals
(6/18/10)
Highlights of IHA's concerns with specific provisions of CMS' proposed rule
affecting inpatient acute and long-term care hospitals, along with IHA's
recommended changes for the final rule. More
information.
- Comment Letter: CMS 1498-P2;
Supplemental Proposed Changes to Hospital Inpatient PPS for Acute Care
Hospitals (6/18/10)
Pursuant to the passage of the Affordable Care Act, CMS issued a proposed
rule implementing changes in the FY2011 Medicare payments in accordance with
certain provisions of the Act. Memo
highlighting IHA's concerns with those provisions.
- IHA Membership Dues Allocable to Lobbying
Expenditures (1/22/10 - password required)
As part of their Medicare cost reporting requirements, providers are
required to report the percentage of dues paid to IHA that represent
lobbying activities. Memo indicating the percentage of dues paid by members
in 2009. More information.
Staff Contact: Tom Jendro: (630) 276-5516
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