Hospitals' Acceptance Of CMS Appeals Offer Hinges On RACs Not Getting Full Fees

Hospitals' Acceptance Of CMS Appeals Offer Hinges On RACs Not Getting Full Fees-insidehealthpolicy: The American Hospital Association is asking CMS to clarify whether Medicare Recovery Audit Contractors will be required to forfeit any of their fees on claims partly paid by the agency under its hospitals appeals settlement offer, warning hospitals may not be willing to accept the settlement if RACs are paid in full. The AHA says that, as a matter of fairness, the RACs should not receive their full fee for claims in situations where CMS partially pays the hospitals. AHA says it has raised the issue with CMS staff numerous times and has not received a definitive answer. “Hospitals have informed us that they consider the decision on RAC fees to be one of fundamental fairness that will impact their evaluation of the terms of CMS's offer,” AHA warns CMS in a Sept. 24 letter.