H.R. 4105, introduced Nov. 7, would place a one-year hold on the Centers for Medicare and Medicaid Services’ (CMS) Medicare recovery audit contractor (RAC) program, which is currently operating in California, Florida, Massachusetts, New York, and South Carolina. Sponsored by Reps. Lois Capps, D-Calif., and Devin Nunes, R-Calif., the bill also directs CMS to provide Congress with a detailed program status report. Some members of Congress are concerned that the RAC program is too burdensome and unfairly penalizes health providers and their patients.
In September, California healthcare providers had informed members of the California congressional delegation that CMS was issuing a “pause” in the RAC process for inpatient rehabilitation claims. According to a statement issued by Capps, CMS did not directly inform Congress of that change in policy and ignored repeated requests for the details of the new policy in writing.
