RAC AUDIT Information Correction as of July 29, 2013

Upon inquiry, CMS informed us that the rescission letters to providers in Region A were sent in error. CMS has apologized for any confusion this has caused.

CMS has now acknowledged that they have instructed audit contractors to limit the look back period for PMD claims to 12 months to keep consistent with the 7 state prior authorization demonstration project which began in August 2012. The twelve month look back period makes the Recovery Auditor review of PMD claims in the non-demo States parallel to the timeframes of claims reviewed under the demonstration. CMS intention was to issue an instruction only with regard to PMD’s.