Bass, Berry & Sims attorney Brian Roark provided insight for an article outlining the Government Accountability Office (GAO) recommendation to incorporate recovery audit contractors (RACs) into the Medicare Advantage (MA) program to monitor improper payments to MA organizations. However, as Brian suggests in the article, “‘[i]nstead of piling on yet another layer of review for MA plans by subjecting them to RAC audits, it would make more sense for CMS to focus on improving the poorly designed and poorly implemented RADV [risk adjustment data validation] audit process.'”
The full article, “GAO: Better Fraud Detection Needed for Medicare Advantage,” was published by Bloomberg BNA on May 11, 2016, and is available online. Brian’s comments were included in the blog post, “Are RACs Coming Soon to a Medicare Advantage Plan Near You?” published by Bloomberg BNA on May 16, 2016, which is also available online.