Some RAC recoveries getting overturned

A July 3 article in Report on Medicare Compliance states that many hospitals are successfully getting the Recovery Audit Contractor (RAC) denials overturned.

The article reports that "CMS appeals contractors and administrative law judges overturned more than 1,000 RAC claim denials appealed by hospitals in four states toward the end of the RAC pilot, which wrapped up in March."

As of Oct. 31, 2007, CMS reported that only 5 percent of RAC determinations were overturned on appeal. A consultant in the article contends that the number is likely to grow because as of that date, few of those cases had advanced to the third level of the appeal process.