The RACs for Region D and Region C added medical necessity reviews to their lists of approved RAC audit issues. HealthDataInsights (HDI), the RAC for Region D, added ten medical necessity reviews to its list of approved issues, while Connolly Healthcare (Connolly), the RAC for Region C, posted 18 medical necessity reviews involving 29 MS-DRGs. The approvals of medical necessity reviews in RAC Regions D and C follow closely behind 18 medical necessity reviews recently approved by CGI, the RAC for Region B. It is important to note that the “new” issues were included in sections already listed on HDI’s approved audit issues lists for review of DRG validations, whereas Connolly listed the medical necessity reviews as separate “new” approved issues.
For more information on RACs or if you need assistance defending a Medicare audit, please visit www.racattorneys.com or contact a Wachler & Associates attorney at 248-544-0888.