Medicare RAC Changes Issuance of Demand Letters
October 11, 2011 – On January 3, 2012, CMS will transfer the responsibility for issuing RAC demand letters to providers from its Recovery Auditors to its Medicare claims processing contractors in order to avoid delays in demand letter issuance. This will mean that when a Recovery Auditor finds that improper payments have been made to a provider, they will submit claim adjustments to your Medicare contractor (MAC). Once reviewed by the MAC, they will generate demand letters for the return of overpayments the same as providers now receive for any other type of Medicare overpayment.
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The Medicare contractor will be responsible for fielding any administrative concerns providers may have such as timeframes for payment recovery and the appeals process. The name of the Recovery Auditor and his/her contact information will be included on the demand letter. Providers should contact the Recovery Auditor for specific questions, such as their rationale for identifying the potential improper payment.
More information will follow as we get closer to the implementation date.
Tags: RAC Audits
