To decrease Medicare costs, Congress mandated a new bureaucracy -- the Medicare Recovery Audit Contractors. RACs are directed to review Medicare payments and second-guess the medical treatment decisions made by health care providers. They are then paid a percentage of what they recover.
Health care providers are human and, as humans, they sometimes make mistakes. If a RAC catches a mistake, that is one thing. But increasingly, they are “second-guessing” medical decisions providers make in emergencies and exploiting ambiguities buried deep within Medicare program manuals. And the system requires a full response to a RAC claim within a short time -- or else any defense may be permanently waived.
Our multifaceted “RAC Defense Force” includes attorneys from our Medical Malpractice Defense, Health Care Corporate and Regulatory, and Appellate Law Practices. RAC audits involve a detailed understanding of complex Medicare payment rules and the requirements of medical necessity. Unlike many consultants, we have years of experience proving that providers’ clinical judgment and decisions are sound. We have combined experts in those areas to counsel you on how to minimize the danger posed by RAC audits and, when needed, to provide you the most effective, cost efficient and timely defense possible.