CMS is beginning contract modifications to current Recovery Auditor Contracts (RACs) to allow auditors to restart some reviews, because of the continued delay in awarding new RACs. Although most reviews will happen automatically, some will be complex reviews of topics chosen by CMS. CMS will award the new round of contracts this year.
CMS had previously announced a suspension of additional documentation requests for Medicare RACs until it finished procuring RAC contracts. RACs will now conduct reviews on claims concerning spinal fusions, outpatient therapy services, durable medical equipment, prosthetics, orthotics and supplies, and cosmetic procedures. CMS also announced that it established a provider relations coordinator to boost program transparency and help providers affected by the medical review process find a resolution.
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