On April 7, the Centers for Medicare and Medicaid Services (CMS) held its regular Open Door Forum (ODF) devoted to hospital and hospital quality issues. The Agency reminded providers that it has extended its "Probe and Educate" program related to Recovery Audit Contractor (RAC) review of hospital inpatient claims through April 30. As of now, relevant claims with dates of service from October 1, 2013, through April 30, 2015 are not subject to formal review by RACs. Though that would lapse as of May 1, 2015, CMS noted that legislation before Congress would extend the period through fiscal year (FY) 2015.
Other topics included wage index appeals, open payments review and coverage of CT scans for lung cancer.
A summary of the Forum from Health Policy Source is available at http://www.new-kyha.com/Portals/5/NewsDocs/ODFSummary040715.pdf.
Post Office Box 436629
Louisville, Kentucky 40253-6629