2.5.10 – CMS Modifies RAC Additional Documentation Request Limits

The Centers for Medicare & Medicaid Services (CMS) recently modified its fiscal year 2010 additional documentation request limitations for the Medicare Recovery Audit Contractor (RAC) program.

Specifically, CMS has expanded the policy on additional documentation request limits so that it now applies to reviews of all institutional claim types.  The limits announced in December 2009 applied only to requests for DRG validation purposes; the same methodology will now be used for reviews of all institutional claim types. CMS will post the limits for physicians, non-physicians practitioners and DMEPOS suppliers at a later date.

For more information, see the new document titled Additional Documentation Limits for FY2010 for Institutional Providers. Additional information on the RAC Program audits can be found at the CMS RAC webpage.