We received the following from one of our three readers:
See this article on the Fed’s RAC audits and collections.
Some points to know.
- The RAC audits are performed by independent contractors nationally whose process is much like those of AMPS
- All hospitals know that the RAC auditors are in place and looking for overcharges and mistakes
- When the RAC auditors find overcharges (they call them overpayments) hospitals are charged a fine plus the hospital has to rebate overpaid funds
- The RAC auditors are technically marshals of the federal government and have open access to all billing and claim detail as well as the hospital’s internal communications (google the article on Beth Israel Hospitals “Turbocharging”)
The Hospital’s, knowing all of this, continue their intentional overcharges to Medicare….the largest PPO in the country. They do so because it’s profitable for them to continue the actions even if they are caught occasionally.
If hospitals are not afraid to overcharge Medicare and face the wrath of the Federal Government, how do you think they consider the overcharges to your company and your clients ?