WEBINAR: RAC Update & New Issues for 2019
Recovery Audit Contractor (RAC) Update and New Issues for 2019
Course Curriculum
This workshop is devoted to reviewing the status of Recovery Audit Contractor (RAC) activities along with consideration to new contracts, scope of works, and various RAC-approved issues.
Included in this program will be events surrounding the RACs and the backlog of appeals at the Administrative Law Judge (ALJ) and Medicare Appeals Council (MAC) level. Office of Medicare Hearings and Appeals (OMHA) has proposed several different ways to address their enormous backlog of appeals, including statistical extrapolation, settlement conferences, and administrative agreements.
A main concern is medical necessity for inpatient admissions. The inpatient issues have sparked the development of the ‘Over 2-Midnights’ rule. CMS has proposed changes to the appeals process in order to expedite the resolution of the backlog of appeals. The expansion of the RACs to the Medicare Advantage Programs is still working with the Risk Adjustment Data Validation (RADV), with a concentration on both comprehensive and condition-specific issues.
This program is perfect for all personnel involved with patient status including physicians, clinical personnel, utilization review staff, compliance and management personnel, coding/billing employees, and all others involved with inpatient admission and observation services.
Speaker
Duane Abbey, PhD, CFP
Dr. Abbey has provided health care consulting services to hospitals, physicians, and medical clinics for more than two decades.
His focus is in the areas of compliance, payment and delivery systems. In addition to consulting, he is an invited presenter for hospital associations, medical societies and other professional groups. Dr. Abbey is an established health care author. The speaker has no real or perceived conflicts of interest that relate to this presentation.