Dr. Fox is president of the ACR. Contact him via e-mail at [email protected].
David A. Fox, MD | Issue: December 2007 |
Dr. Fox is president of the ACR. Contact him via e-mail at [email protected].
What you need to know about the Recovery Audit Contractor program
Ready, Set … RAC Audits
In March of 2008, by Section 302 of the Tax Relief and Health Care Act of 2006, the Centers for Medicare and Medicaid Services’ (CMS) Recover Audit Contractor (RAC) program was made a permanent addition to the Centers’ goal preventing fraud, waste, and abuse in the Medicare system.
The world in which we currently practice is not the same one we knew five to 10 years ago. Insurers second-guess our decisions and create numerous hurdles for us to overcome before our patients can be treated. Government agencies are seeking ways to reduce healthcare expenditures and improve what they perceive as a lack of quality and consistency in healthcare delivery. These groups, as well as Congress and employers (who purchase benefits for their employees), have begun a concerted effort to grade rheumatologists on the basis of what they perceive to be quality and efficiency and then pay us according to those criteria.