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David McGill Blogger

The Mega-RAC is Here

Posted by David McGill | January 06, 2015

Medicare has announced the award of a new Recovery Auditor contract to Connolly, Inc. Connolly currently handles audits for Medicare Region C, but the new contract is national. 

What does this mean for you?

Medicare's announcement is short on specifics. Will this new national RAC specifically focus only on DME, home health and hospice claims, or will orthotic and prosthetic claims also fall under its purview? The guidance published so far doesn't allow us to draw any definitive conclusions. 

More generally, we do expect RAC audit activity to ramp up during 2015. While CMS announced a suspension of RAC audits in early 2014, RAC activity did restart last August. 

In the meantime, you need to make sure that your claims satisfy Medicare's coverage requirements set forth in the applicable Local Coverage Determinations. Use the resources available on Ossur's Reimbursement Resources page to help you. If you want more detailed assistance, we encourage you to use our Strategic Partner, The Audit Team, who you can reach at [email protected]

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If you have any questions for Össur’s Reimbursement Team or about Össur’s Reimbursement Services, please contact us at [email protected]