Recovery Audit Contractor (RAC) Update and New Issues for 2019 (T6028) Duane Abbey, PhD, CFP, Management Consultant and President Abbey & Abbey Consultants The price for this webinar is $225 per phone line. This workshop is devoted to reviewing the status of Recovery Audit Contractor (RAC) activities along with consideration to new contracts, scope of works, and various RAC-approved issues. Included in this program will be events surrounding the RACs and the backlog of appeals at the Administrative Law Judge (ALJ) and Medicare Appeals Council (MAC) level. Office of Medicare Hearings and Appeals (OMHA) has proposed several different ways to address their enormous backlog of appeals, including statistical extrapolation, settlement conferences, and administrative agreements. A main concern is medical necessity for inpatient admissions. The inpatient issues have sparked the development of the ‘Over 2-Midnights’ rule. CMS has proposed changes to the appeals process in order to expedite the resolution of the backlog of appeals. The expansion of the RACs to the Medicare Advantage Programs is still working with the Risk Adjustment Data Validation (RADV), with a concentration on both comprehensive and condition-specific issues. This program is perfect for all personnel involved with patient status including physicians, clinical personnel, utilization review staff, compliance and management personnel, coding/billing employees, and all others involved with inpatient admission and observation services. Continuing Education Credits Georgia Hospital Association is an approved provider of continuing nursing education by the Alabama State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Approved for 1.5 Contact Hours The Georgia Hospital Association Research & Education Foundation is accredited by the Medical Association of Georgia to provide continuing medical education for physicians. The Georgia Hospital Association Research & Education Foundation designates this live activity for a maximum of 1.5 AMA PRA Category1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. If you are registering from an out-of-state hospital association, please contact Bess Zappa at 770-249-4542.