"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

    ReplyDelete

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"


Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

Share PTD with your Peers!

American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.