CMS to Resume Medicare Part B RAC Reviews

Carl J. Pucci in Finance & Reimbursement

CMS has sent notice that it is resuming Part B therapy claim reviews in excess of $3,700 per beneficiary per year. The Medicare Recovery Audit Contractors (RACS) will be initiating such reviews for claims paid between March 1, 2014 and December 31, 2014.

Attached is the AHCA bulletin with complete details. AHCA is seeking further clarification as it has serious concerns with the arbitrary $3,700 threshold established for reviews, and will continue to advocate for therapy program reform.

NYSHFA CONTACT
Carl Pucci
Director, Finance & Reimbursement
518-462-4800, ext. 36