Medicare's recovery audit contractor program: inpatient rehabilitation facilities are taking back takebacks, but enough?

Am J Phys Med Rehabil

Department of Rehabilitation Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA.

Published: May 2011

A perfect storm had been brewing in the last decade: Medicare payment mistakes; Medicare waste, fraud, and abuse; fuzzy medical necessity definitions; erroneous coding; and a strained national budget. The United States Congress responded by inserting Section 306 into the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Section 306 called for the correction of Medicare payment problems by establishing the Recovery Audit Contractor program as the vehicle for the Centers for Medicare & Medicaid Services to recoup Medicare overpayments as far back as 3 yrs from its healthcare providers and to return underpayments to them. The legislation allowed for Medicare to contract with private firms to follow the money and earn a cut. Caught in the eye of the storm, Medicare providers combined are giving back more than they get back. Inpatient Rehabilitation Facilities are taking back takebacks-but enough to remain viable?

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Source
http://dx.doi.org/10.1097/PHM.0b013e318214ec54DOI Listing

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