CMS to Pause Recovery Auditor Audits

February 19, 2014
Rick Gawenda

On February 18, 2014, the Centers for Medicare and Medicaid Services (CMS) announced they will pause recovery audits since they are in the procurement process for the next round of Recovery Audit Program contracts. This will allow the Recovery Auditors time to complete all outstanding claim reviews and other processes by the end date of the current contracts.  In addition, a pause in operations will allow CMS to continue to refine and improve the Medicare Recovery Audit Program.

February 21, 2014 is the last day a Recovery Auditor may send a postpayment Additional Documentation Request (ADR).
February 28, 2014 is the last day a MAC may send prepayment ADRs for the Recovery Auditor Prepayment Review Demonstration.
June 1, 2014 is the last day a Recovery Auditor may send improper payment files to the MACs for adjustment.

To read more, click HERE.

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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