On August 4, the Centers for Medicare & Medicaid Services (CMS) announced that due to the continued delay in awarding new Recovery Auditor Contractor (RAC) contracts, it is initiating contract modifications to the current RAC contracts to allow the Recovery Auditors (RAs) to restart some reviews. Most reviews will be done on an automated basis, but a limited number will be complex reviews of topics selected by CMS.
According to a communication CMS sent to congressional health staff members from Lauren Aronson, director of the office of legislation at CMS, informing them of the decision, the RAs “will conduct a limited number of automated reviews and a small number of complex reviews on certain claims including, but not limited to: spinal fusions; outpatient therapy services; durable medical equipment, prosthetics, orthotics and supplies; and cosmetic procedures.”
Editor’s note: This story was adapted from materials provided by Health Data Management.
