On November 30, 2011, the United States Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that eligible providers that satisfy the Medicare and Medicaid EHR Incentives Program Stage 1 Meaningful Use criteria in 2011 may wait until 2014 to comply with CMS‘s Stage 2 criteria.
[This report is the second of a two-part article on this subject.]
RACs Incentivized More for Part A Claims than for Part B Claims
CMS incentivizes the Medicare Recovery Audit Contractors (RACs) by weighting their contingency fees based upon the type of improper payments found by RAC auditors. We previously reported that RACs do not often get their full contingency fee, ranging from 9% to 12.5%, when they correctly identify an overpayment made to a provider. Instead, although they receive their full contingency fee for finding any underpayments, they only receive 75% of their fee for Inpatient claims (from hospitals and other healthcare facilities), and only 50% for Outpatient claims (from physicians and other healthcare providers). Continue reading
On March 31, 2011, the U.S. Department of Health and Human Services (“HHS”) issued over 400 pages of proposed regulations on the structure and operation of Accountable Care Organizations (“ACOs”) under The Patient Protection and Affordable Care Act(“PPACA”).