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LDH to roll out RAC audits

Tuesday, February 21, 2017  
Posted by: Terri Watson
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Louisiana Department of Health (LDH) to Roll out Medicaid RAC Audits 
To help our members understand and better prepare themselves for these types of audits, we suggest you visit the Physicians Advocacy Institute’s (PAI) medical audit toolkits and resources webpage. The LSMS was one of 19 state medical society signatories that filed Multi-District Litigation (MDL) in 2000 on behalf of physicians against for-profit health insurance companies. The PAI was established in 2006 with funds from the MDL settlements  and works, in part,  to develop projects and tools for physicians’ medical practices. 

Physicians Advocacy Institute (PAI) / American College of Emergency Physicians (ACEP) Toolkit for Physicians Facing Medical Audits - The Physicians Advocacy Institute (PAI) has collaborated with the American College of Emergency Physicians (ACEP) to develop a Toolkit for Physicians Facing Medical Audits.  The Toolkit provides practical information and tips to guide physicians in anticipating medical audits, responding to auditors’ requests for medical records, and appealing erroneous audit findings. The Toolkit also includes detailed information regarding the various types of governmental and private payer audits, appellate procedures, and extrapolation methodologies used by some payers to calculate alleged overpayments. Click here to visit the site. 
The Office of the State Register will publish the following Emergency Rule in the February 20, 2017 issue of the Louisiana Register:

Department of Health, Bureau of Health Services Financing 
Recovery Audit Contractor Program, effective March 16, 2017  

To view Emergency Rule, click here


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Louisiana State Medical Society

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