04/16/2019

Recent RAC Monitor Articles

This edition includes an articles on......

Recent RAC Monitor articles you may find informative...

OIG Inspector Daniel Levinson Resigns

The head of the federal healthcare oversight body was a popular guest on Monitor Mondays. Daniel Levinson, Inspector General of the U.S. Department of Health and Human Services (HHS), is stepping down from his post at the end of May, following nearly 15 years in his position as healthcare’s top… READ MORE

An Overview of AMA’s E&M Revisions for 2021

AMA’s changes are complementary to the CMS proposed changes to this code set.  The Centers for Medicare & Medicaid Services (CMS) is moving quickly on its strategies for outpatient office evaluation and management (E&M) services, targeted for implementation in 2021, and the American Medical Association (AMA) is working hard to…  READ MORE

Beware: The MIPS Shell Game

Weighting changes will be implemented for the 2019 calendar year. Important changes for the 2019 calendar year in healthcare include Merit-Based Incentive Payment System (MIPS) category weighting changes. The quality category will decrease in importance, with a shift of 5 percent, going from 50 to 45 percent of the overall…  READ MORE

CMS Revises and Details Extrapolation Rules

Effective Jan. 2, 2019, the Centers for Medicare & Medicaid Services (CMS) radically changed its guidance on the use of extrapolation in audits by Recovery Audit Contractors (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), and the Supplemental Medical Review Contractor (SMRC).  READ MORE