The Tax Relief and Health Care Act of 2006 contains a
provision that allows for the Centers for Medicare &
Medicaid Services (CMS) to unleash Recovery Audit
Contractors (RACs) onto homecare agencies. Because RACs work on a contingency basis, they don't get paid until they find a mistake.
How much revenue could this program generate?
The pilot program in only a few states recouped hundreds of millions of dollars in overpayments, taking away revenue from hospitals. This summer, CMS will provide information about homecare agencies to RACs...and the audits will begin.
In this audio conference series, you will learn:
- The threats that RACs present
- What’s at risk now and what challenges may be lurking
- How to reduce exposure and eliminate the danger
- How to conduct your own internal audit
- What tools to use to defend your agency from denial
- How to survive a RAC review
- How to respond to denials and follow through on the appeal process
Session 1: RACs and Threats to Your Agency
Thursday, May 21, 2009
Audio Recording
This session will discuss:
- The CMS rationale for the RAC program and how it came to be
- The RACs objectives—who they are, how they will operate
- How to respond to a RAC request or information
- Major concerns facing homecare agencies
- Coverage, utilization, and practice issues at risk
Session 2: Preparing for RAC Scrutiny
Thursday, June 18, 2009
Audio Recording
This session will discuss:
- How the lessons we learned in ORT can
help you prepare for the RAC program
- What factors will be used to expose
target agencies
- Ways to identify your agency’s risks
- Pre-emptive strikes such as clinical
record audits, staff education, and
documentation techniques
- Home health aide and medical social
services involvement with the RAC program
Session 3: The RAC Audit: Defensive Strategies
Thursday, July 16, 2009
Session Times: 1–2 p.m. Central Daylight Time (CDT)
2–3 p.m. Eastern • 12–1 p.m. Mountain • 11–12 p.m. Pacific
This session will discuss:
- A primer on fraud and the role of RACs
in the CMS effort to control this abuse
- Why “reasonable and necessary care”
will be a central focus
- Strategies for nurses and therapists
to strengthen reasonable and
necessary care
- “Suspicious” practices involving ranges,
physician authorization, occupational
therapy services, and more
Session 4: After a RAC Audit: Your Rights and Appeals
Thursday, August 20, 2009
Session Times: 1–2 p.m. Central Daylight Time (CDT)
2–3 p.m. Eastern • 12–1 p.m. Mountain • 11–12 p.m. Pacific
This session will discuss:
- The penalties and punishments that
RACs and fraud investigators can
impose on agencies
- An agency’s rights
- The steps in the appeals process—how
it works, tips to consider, and the results
- An action plan for dealing with RACs
in the future
Beacon Health is a Division of HCPro, Inc.
HCPro, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center Commission on Accreditation.
This educational activity for 1.0 (per session) nursing contact hours is provided by HCPro, Inc.
The Presenters for this Series are: Diane J. Omdahl, RN, MS and Pam Warmack, RN, C CHCE, HCS-D, COS-C
