MACs + RACs = Audits
Both RACs and MACs audit providers to ensure that they’re paid correctly for services provided. But once a MAC audits a service, a RAC cannot. And vice versa. So, does that mean there might be a little friendly competition between them that could result in more audits for providers? This article written by Andrea Kraynak for HealthLeaders Media explores that notion.
Medicare Administrative Contractors (MAC) Fax Scam Alert
A 06/18/09 update on the Centers for Medicare and Medicaid Services (CMS) Home Health, Hospice & Durable Medical Equipment Open Door Forum website indicates that CMS has become aware of a scam. The scam entails the submission of faxes to practices from perpetrators posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax tells physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.
Medicare FFS providers, including physicians and non-physician practitioners, should be wary of this type of request. If you receive a request for information in the manner described above, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the address found in the download section of the CMS.gov website found at http://www.cms.hhs.gov/MLNGenInfo/ or http://www.cms.hhs.gov/MedicareProviderSupEnroll .