Proposed Expansion of Medicaid RACs Includes Focus on Managed Care Payments

Monitor Mondays

The Government Accountability Office (GAO) is recommending expansion of the Medicaid Recovery Audit Contractors (RACs) program, to include auditing of payments made to managed care organizations (MCOs), according to a GAO report released in June.

Launched in 2011 as a consequence of the Patient Protection and Affordable Care Act (PPACA) by the Centers for Medicare & Medicaid Services (CMS), the Medicaid RACs were purported to be aggressive in their recouping of alleged Medicare Fee-for-Service (FFS) overpayments. They could now be poised to expand into the rapidly growing MCO plans.

During the next live edition of Monitor Mondays, Dennis R. Jones, senior director of revenue cycle at Jefferson Health, will report on this developing story.

Broadcast segments will also include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, vice president of R1 RCM, will make his Monday Rounds.
  
• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullen, will report the latest news about auditors.
  
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.
  
• Legislative Update: Folana Houston, assistant general counsel for Zelis, will report on current healthcare legislation.

Chapters

1. Proposed Expansion of Medicaid RACs Includes Focus on Managed Care Payments (00:00:00)

2. Ronald Hirsh, MD (00:00:52)

3. Knicole Emanuel, Esq. (00:04:52)

4. RACmonitor Commercial (00:10:12)

5. David Glaser, Esq. (00:11:02)

6. Folana Houston, MPA (00:15:38)

7. Dennis Jones (00:19:42)

8. RACmonitor Commercial (00:27:56)

9. Q&A with David Glaser (00:28:52)

10. Closing (00:30:24)