CMS Reduces Medicare RAC Minimum Record Request Limits
April 8—As of April 15, recovery audit contractors (RACs) may request a lower number of medical records from Medicare providers other than physicians and suppliers, according to documentation from the Centers for Medicare & Medicaid Services.
RACs may issue a minimum request of 20 records in a 45-day period from hospitals and other provider campuses, down from a previous minimum of 35 records. Also, only 75 percent of a hospital’s record request limit may be used for a particular claim type—such as acute hospital inpatient or hospital outpatient—down from the previous 100 percent.
The maximum number of record requests per 45 days is still 400, while providers with more than $100 million in MS-DRG payments still have a cap of 600.
Publication Date: Monday, April 08, 2013