Providers will be under a great deal more examination and scrutiny from Medicare and Medicaid auditing bodies that are scouring for evidence of improperly paid claims as well as fraud and abuse, reports Carla Engle, MBA, in this Thursday's edition of RACMonitorEnews. "Everyone is hurriedly getting ready for the inevitable Recovery Audit Contractor (RAC) audits coming up as soon as next month," she reports. But she, notes, the RACs are also authorized to report suspected fraud and abuse.
Interdepartmental referrals may happen, too, particularly if there are allegations of suspected fraud or abuse, especially because of the success rates of combined departmental efforts, like Medi-Medi, she notes. For a complete description of seven other auditing agencies, be sure to read this Thursday's RACMonitorEnews.