Supplemental Medical Review Contractors Are Ones to Watch


Amy Lerman, an Associate in the Health Care and Life Sciences practice, in the Washington, DC, office, wrote an article titled "Supplemental Medical Review Contractors are Ones to Watch." (Read the full version – subscription required.)

Following is an excerpt:

As Medicare providers know all too well, the Centers for Medicare & Medicaid Services has implemented a multitude of program integrity auditing initiatives, each with a slightly different focus, but all with an eye toward the goal of detecting and correcting improper payments to and from Medicare. These efforts, while an important step toward improving waste, fraud and abuse in the Medicare program, have come at tremendous expense of time and money for providers. Yet, as providers have enjoyed a temporary reprieve from recovery audit contractors ("RACs"),[1] the newest addition to the alphabet soup of contracting entities, the supplemental medical review contractor ("SMRC"), has been picking up the program integrity auditing slack.