title: The RACs are back: auditors to start performing complex reviews.
abstract: The Recovery Auditor program is cranking back up again after almost a year's hiatus, but despite the Centers for Medicare & Medicaid Services' plans to improve the program and issue new contracts, the audits will be conducted by the same auditors under the same rules. Auditors are likely to target short stays and other weak areas the Medicare Administrative Contractors identified during Probe and Educate, according to Elizabeth Lamkin, MHA, chief executive officer and partner in PACE Healthcare Consulting, LLC, based in Beaufort County, SC. CMS has not made any clarifications to the two-midnight rule, and auditors may begin auditing hospitals for compliance beginning April 1. The Outpatient Prospective Payment System (OPPS) final rule clarified the requirement for physician certification, saying that the order to admit must be signed by the treating physician and the justification for the admission, the expected length of stay, the treatment plan, and the discharge plan do not have to be a separate document but can be part of the history and physical.
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D054869:Clinical Audit; D003284:Contract Services; D004469:Economics, Hospital; D007345:Insurance Claim Review / Q000458:organization & administration*; D014481:United States