Section 6411 of the PPACA required States to establish Medicaid RAC programs. As of February 1, 2012 every state had either submitted a plan for a Medicaid RAC program or had one approved. This means going forward, providers who are enrolled in Medicare and Medicaid will need to be aware of both Medicare and Medicaid RACS. This provides yet another layer of auditing of claims that can lead to recovery of payments if providers are not diligent in their claims process. As with the Medicare RAC program, providers should anticipate more active audit activity, as many Medicaid RACs are paid on a contingency fee basis. Home health and hospice providers, who have been largely ignored by Medicare RACs should not expect Medicaid RACs to take a similar approach.
Join Robert W. Markette, Jr. for this 60-minute information packed event, where he will review the Medicaid RAC statute and regulation to provide an overview of how these programs work and where they differ from the Medicare RAC programs. Get reviewed on areas that a Medicaid RAC is most likely to focus on. Our speaker will also address responding to document requests, including time frames for responses, processes to have in place to ensure timely responses, and when to consider involving counsel.
Also, Robert will discuss responding to findings and the appeals process.
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Who should attend? Claims and billing staff; administrators, compliance officers
For more than a decade, Robert W. Markette, Jr., CHC, has focused his practice on representing home health, hospice, private duty and DME providers in all aspects of their operations. With more than a decade of experience in working with these industries, Robert has developed a reputation for understanding the operational, compliance and legal/regulatory issues facing homecare providers.