Bounty hunters. We don’t need their scum.

Bounty HuntersDavid Bennett at Medical Economics reports on the Medicare Recovery Audit Contractor (RAC) program:

[P]rivate firms hired by CMS are charged with identifying overpayments and underpayments of the more than 1.2 billion Medicare claims submitted by U.S. health-care providers each year, including hospitals, physicians, skilled nursing centers, labs, and ambulance companies.

Since its 2005 inception, the program is reported to have collected nearly $1 billion dollars.  The program has nevertheless come under fire:

“It’s a bounty-hunter program,” says Elizabeth McNeil, vice president of federal government relations for the California Medical Association. “[RACs] have cost California physicians resources, time, and hassles for the modest amount of money they have collected.”

What’s going to happen when the RAC expands to cover all 50 states shortly before the ICD-10 code set is implemented which coincides with the planned 21% Medicare pay cut for physicians?  And, of course, we already have the never events nonsense.  One can almost convince one’s self that the government, realizing that Medicare is financially doomed, is trying to get all physicians to opt out of it so Medicare patients will have to pay their own medical bills.

The next few years are going to be interesting.

One Response to “Bounty hunters. We don’t need their scum.”

  1. Dr. Bobb,

    If you are a solo practice physician the RACs may be ‘much ado about nothing’.

    I have posted evidence that the RACs, the permanent RACs especially, will be preferentially targeting large inpatient hospitals, not small practices.

    Medicare rates are set higher than average practice costs.

    Medicare is not the enemy.

    Large insurers reimbursing us below our average costs are what we need to worry about.


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