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RECOVERY AUDIT CONTRACTOR (RAC)
We have extensive experience with RAC audits and appeals, working directly with healthcare entities subject to RAC audits.
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We have represented Independent Diagnostic Testing Facilities (“IDTFs”), mobile leasing entities, radiology group practices, and other imaging providers.
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We provide assistance and guidance through the legal process focused on the goal of resolving your matter successfully and efficiently.
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America’s Healthy Future Act of 2009

On September 22, 2009, the U.S. Senate’s Chairman’s Mark released a draft legislation regarding the future of healthcare in the United States. Some notable points include:
– Limiting physician referrals only to permit hospitals that meet certain exemption requirements, which would be more stringent than the current Medicare requirements;
– Establishing a process to update HIPAA standards periodically;
– Increasing transparency in the physician-manufacturer relationship involving payments and transfers of value and physician ownership or investment interests in manufacturers;
– Including in the in-office ancillary exception, for designated health services, that the referring physician inform the patient that s/he is not required to obtain services from the referred physician or a physician affiliated with the referring physician;
– Screening all providers and suppliers prior to the Secretary granting Medicare billing privileges;
– Expanding and consolidating provider databases with a “national patient abuse/neglect registry into a centralized sanctions data system;”
– Imposing a compliance program for Medicare and Medicaid providers as a condition of participation;
– Requiring Medicare and Medicaid providers and suppliers to repay overpayments when identified through an internal audit;
– Establishing a self-disclosure protocol allowing providers to voluntarily disclose instances or potential instances in which s/he has violated the physician self-referral law; and – Expanding the RAC program the Medicare Part C, Medicare Part D, and Medicaid.

For more information, please contact Abby Pendleton, Esq., Jessica L. Gustafson, Esq., Carey F. Kalmowitz, Esq., Adrienne Dresevic, Esq., or Robert S. Iwrey, Esq. at (248) 996-8510 or visit The HLP website.

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