Recovery Audit Contractor (RAC)
The AHA continues to work with government stakeholders to improve the RAC program and prevent abuses that prevent hospitals from receiving payment for necessary medical care. The AHA also provides education to members to help prevent payment denials and navigate the Medicare appeals process in the…
In recent years, the Centers for Medicare & Medicaid Services has drastically increased the number of program integrity auditors that review hospital claims to identify improper payments. These audit contractors include recovery audit contractors (RACs) and Medicare administrative contractors (…
The AHA Friday asked a federal judge to require the Department of Health and Human Services to implement three practicable solutions to reduce the backlog of Medicare claims appeals at the administrative law judge level: offer reasonable settlements to hospitals and other Medicare providers; delay…
In an AHASTAT blog post today, AHA President and CEO Rick Pollack responds to a recent Wall Street Journal analysis that questioned the recent reductions in hospital readmissions. “Here is what the numbers show,” Pollack writes.
MAC/RAC Demand Letter
Sample MAC/RAC Demand Letter