RAC Audits (Medicaid)
Skewes, Ed
Description
Collection
Title:
RAC Audits (Medicaid)
Creator:
Skewes, Ed
Date:
10/9/2012
Text:
RAC Audits (Medicaid)
Given the state of Virginia has initiated steps for Medicaid RAC audits, it seems reasonable that several other states will pursue this paradigm. Whether this action is to recover funds from fraud or abuse, or it is merely justification to recover funds, remains to be seen.
Having read other concerning posts on the O&P list serve regarding Medicare audits, my question is, how aggressive do you think the Medicaid audits will be in their attempts to recover funds?
Will a signed LMN and detailed Rx be enough justification to prevent recovery of funds if the physician outpatient notes are vague?
If not, then won't we (practitioners), be required to ensure that physician outpatient notes include the patients K level, type of knee, prosthetic foot, etc., and the reason the physician selected those devices for the patient?
Edward Skewes CPO
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (813) 281-0300.
Given the state of Virginia has initiated steps for Medicaid RAC audits, it seems reasonable that several other states will pursue this paradigm. Whether this action is to recover funds from fraud or abuse, or it is merely justification to recover funds, remains to be seen.
Having read other concerning posts on the O&P list serve regarding Medicare audits, my question is, how aggressive do you think the Medicaid audits will be in their attempts to recover funds?
Will a signed LMN and detailed Rx be enough justification to prevent recovery of funds if the physician outpatient notes are vague?
If not, then won't we (practitioners), be required to ensure that physician outpatient notes include the patients K level, type of knee, prosthetic foot, etc., and the reason the physician selected those devices for the patient?
Edward Skewes CPO
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (813) 281-0300.
Citation
Skewes, Ed, “RAC Audits (Medicaid),” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/234069.
