What are the target areas for the RACs?
RAC audits are centered around a wide range of perceived provider errors initially uncovered by both Medicare fiscal intermediaries and the Office of Inspector General – as well as through contracted medical review relationships such as Comprehensive Error Rate Testing (CERT) organizations and the QIO Hospital Payment Monitoring Program (HPMP). The project results for each year identify those areas of focus. Many hospitals were audited for Inpatient Rehabilitation Facility admissions, chest pain related to one day stays, respiratory with ventilator coding, excisional debridement documentation, colonoscopies, etc.
