The Centers for Medicare and Medicaid Services (CMS) is expanding an auditing program to include Medicare Part C (Medicare Advantage plans), which may increase the administrative burden for physicians and the likelihood that your practice will be audited.
As mandated by the Affordable Care Act (ACA), CMS is working to implement the Recovery Audit Contractor (RAC) program for Part C and prescription drug coverage plans (Part D).
The ACA amends the existing Medicare fee-for-service RAC statute, giving CMS the authority to enter into contracts with RACs for the purpose of identifying overpayments and underpayments in Medicare Parts C and D. Additional guidance is expected from CMS in the coming months.
Due to advocacy efforts by the American Medical Association, CMS made
several improvements to the expanded RAC program earlier this year.