RAC’s: A different perspective
Kyle commented on RAC’s in his post on March 5th. The incentives underlying RAC’s leaves much concern for those receiving (or soon to be receiving) audits, and this post by Dr. Rich at the Covert Rationing Blog makes the point that even practice owners and managers that try with all their might to comply with the ever-changing and difficult-to-understand Medicare regulations are left with little clarity in the matter, making compliance near impossible. Unfortunately, this doesn’t hold a lot of weight as compared to the generous percentage of collections that provides the fuel needed for RAC’s to go for the throat during the recovery audit process.
The conclusion…if you haven’t already, invest in the companies involved with the recovery audits, because there is a lot of money that’s going to be made in the process.
The RACs are paid by commission. Essentially they are bounty hunters, and they get to keep 20% of whatever they collect. According to the Associated Press, hospitals and providers are just a tad worried that these contractors, being so generously incented, will prove a little overzealous in their enthusiasm to find fraud. But worried auditees should not look for sympathy from the public. “A little zealotry is what we’re looking for on the part of the taxpayers,” said Leslie Paige, spokeswoman for Citizens Against Government Waste. “We think it’s about time.” Indeed – everybody can get behind fighting fraud, which is what makes the fraud gambit such a powerful tool for covert rationing.
It is good to be an RAC, and, DrRich suggests, it would also be good to own stock in whichever companies are contracted to perform the audits. These outfits are about to harvest the vast bounty of obfuscation that Medicare has been carefully cultivating for 40 years, and has been carefully fashioning as fraud-traps for a somewhat shorter period of time.
