Home health agencies and hospices may not technically be under Recovery Audit Contractor (RAC) reviews just yet, but at least one RAC is investigating areas that affect home care & hospice.
Health Data Insights (HDI), the RAC contractor for Region D, posted 66 new approved issues for review in January. Most of them apply to hospitals, but HDI is also approved to review durable medical equipment topics, two of which affect home health and hospice. The RAC will look for DME claims improperly paid for beneficiaries in a hospice stay. This could cause suppliers to come knocking on hospice doors for payment for claims dating as far back as Oct. 1, 2007.
CMS approved “Medical Supplies and Home Health Consolidated Billing” as another RAC issue on Jan. 6. The RAC will look for DME and supply claims paid by Medicare that should have been covered by an HHA under bundling back to Oct. 1, 2007, which could cause suppliers to go back and ask agencies for those payments.
While this has not yet been an activity for Minnesota RAC, now that one RAC has identified home health and hospice issue, the others won’t be too far behind. Expect to start seeing letters form the RAC (in region D at least for now). When you receive a request for information, respond promptly. RAC demonstration noted a significant percentage of claims recouped simply because the provider failed to provide documentation in a timely manner. Don’t donate money to Medicare because you did not respond in time!
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