CMS has announced a series of "Nationwide RAC 101 Calls" scheduled for late April and early May.

(see http://www.cms.gov/RAC/03_RecentUpdates.asp#TopOfPage )

If you are this preoccupied by RAC issues, however, you may not be very interested in the prepared content of these calls. But just because the scheduled content may only be useful for the uninitiated, do not think that these calls will not be valuable.

"These are basically a repeat of the provider outreach we have completed in the past," says Connie Leonard, Director of the CMS Division of Recovery Audit Operations.  "They will be completed by CMS staff and will be an overview of the RAC process.  While some new issues will be discussed, it will only be as examples of issues the RACs may be reviewing."

The four calls are scheduled for different provider types; April 28 @ 1:00 pm EST for the general audience, May 4 @ 1:00 pm EST for Home Health and Hospice providers , May 5  @ 1:00 pm EST for DME providers, and May 12 @ 1:00 pm EST for physicians.

Content for Sessions

Although these are discrete sessions, the content presented will be very much the same.  Included will be the comparison of the RAC Demonstration Project with the Permanent RAC (External validation process: Mandatory!) A summary of the RAC Review Process (Two types of review: Automated and Complex) and an example or two of posted approved issues for review (the DME session is certain to include the tricky "Wheelchair Bundling.")

Earlier, in a March 24 presentation for AHIMA also titled RAC 101, Melanie Combs-Dyer, RN Senior Technical advisor for CMS provider Compliance Group, summarized the current status of the RAC National program as "All RACs have data" and "All states are now eligible for review."

The best part of any CMS education session is always the Question & Answer period.  You will most likely be able to ask any questions that you have regarding RAC issues or highlight any problems that your hospital may be having with the current RAC.

CMS is usually conservative with its responses (they won't hesitate to promise a reply at a later date) but the answers provided to you and others can make these RAC 101 calls more than worthwhile.

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About the Author

Dennis Jones is the director compliance services for CBIZ KA Consulting. While Dennis is recognized as a leading RAC issues expert, his expertise covers a wide variety of topics including Managed Care, Uncompensated Care, Medicare and Medicaid Compliance, HIPAA, and Process Improvement. As a result he has spoken previously for NJHA, World Research Group, and various state chapters of HFMA, AAHAM, and AHIMA. Dennis is a past-president of the New Jersey Chapter of AAHAM and has held senior management positions in provider, IT vendor and reimbursement consultant arenas.

He is a graduate of the Pennsylvania State University with a degree in Health Planning and Administration and hopes to be able to afford season football tickets some day.

Contact the Author

drjones@CBIZ.com