"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Thursday, July 17, 2008

Physical therapists take note of Medicare audit process

The MEDICARE RECOVERY AUDIT CONTRACTOR (RAC) Program: An Evaluation of the 3-Year Demonstration June 2008
report is available here (downloadable PDF).

Interpretations differ but most call the program a success citing the high amount recovered and the low amount recovered on appeal.

The Recovery Audit Contractors have recovered more than one billion dollars.

Amounts overturned on appeal were low...

"As of March 27, 2008, providers had chosen to
appeal 14.0 percent of the RAC determinations.
Of all the RAC overpayment determinations, only
4.6 percent were overturned on appeal."

Overpayments by provider type showed that physicians (which include outpatient physical therapists) accounted for only 2.5% of the total overpayments collected.

While some feel that the RAC program is on a 'bounty hunt' the results of this report that, not only are RACs here to stay but that soon they will be in all 50 states.

1 comment:

  1. The Centers for Medicare & Medicaid Services recently released an update document to the report evaluating the 3-year Medicare recovery audit contractor demonstration project. For more information, visit: http://medicareupdate.typepad.com/medicare_update/2008/09/the-cms-recentl.html


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