RAC/Overpayment Audits

RAC/Overpayment Audits

Sara Beck

9/6/2013

Just a quick suggestion regarding RAC/Overpayment audits.  I know a lot of you have been, and continue to wait, months, even years, to receive a hearing from an Administrative Law Judge (ALJ).  If you are unaware, the Social Security Act states that ALJ's have 90 days to conduct a hearing and issue a decision.  If they do not comply with the 90 day's, you, as a provider, have the right to appeal to the next level; which would be the Departmental Appeals Board.  They also have 90 days to issue a decision.  If they, also, do not comply with the 90 day limit, you have the right to request judicial review in federal district court (the last level of appeal).  I know it is frustrating to wait for an ALJ to set a hearing date. By this point, Medicare has already recouped your money so you are stuck waiting years to have the opportunity to get that money back.  So, my suggestion is to keep appealing.  If the ALJ 90 day limit passes, appeal to the
 next  level.  Keep appealing until you reach District Court.  I don't believe that District Courts will be pleased to be flooded with all of our appeals.  Hopefully, this will, at the very least, hold each level of appeal accountable to the time limitations outlined in the Social Security Act.   It is unconscionable that providers are waiting 2 years for a hearing date from an ALJ when, technically, they should only wait 90 days.  If you have any questions or need help, please do not hesitate to contact me directly. 
 
Sara Beck
San Joaquin O & P