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CMS Announces Modified Additional Documentation Request Limits for Institutional Providers

On January 28, 2010, the Centers for Medicare and Medicaid Services (CMS) announced modified additional documentation request limits for institutional providers for the RAC program in FY 2010. The limits will be annually set by each RAC in accordance with this CMS guidance to create a per campus cap on the maximum number of medical records that may be requested within a 45-day period.

In accordance with this announcement, the RAC for Region D, HealthDataInsights (HDI), has announced that it will soon begin sending Additional Document Request (ADR) letters to hospitals in the Region. The ADR letters will be mailed to the contact names listed on HDI’s provider portal. If no contact information has been provided, the letter will be sent to the hospital’s compliance officer or the chief financial officer.

For additional information regarding the RAC program and relevant updates, please visit our RAC website at https://www.wachler.com/ or contact a Wachler & Associates attorney at (248) 544-0888.