Letter to Dr. Berwick Raises Concerns over Medicaid RAC Program

Physician organizations have sent a letter to CMS Administrator Donald Berwick, MD, raising “concerns about the perverse incentive structure and burdensome nature of the Medicare Recovery Audit Contractor (RAC) program.” Signed by the North Carolina Medical Society, AMA and dozens of other state and specialty organizations, the letter supports education and outreach as the best way to reduce improper coding. The organizations want CMA to develop streamlined and straightforward requirements for the Medicaid RAC program “to ensure efficient and high quality care delivery.”

While supportive of CMS’s efforts to identify improper or fraudulent activity in the Medicaid program, the organizations believe that the Proposed Rule concerning the Medicaid RAC Program “does not provide sufficient guidance to states in establishing and implementing their Medicaid RAC programs.” The groups also urged CMS to be mindful of the many challenges physicians are facing as a result of the health system reform law, including implementation of new health information technology, and the transition to ICD-10-CM and ICD-10-PCS codes.

Click here to read the letter.


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