Ruling Bars Medicare Claim Reviewer Scrutiny, 9th Circ. Told

Law360, New York (November 7, 2012, 2:21 PM EST) -- Health care groups on Monday urged the Ninth Circuit to revisit its decision letting federal health officials bar administrative reviews of contractors' decisions to reopen Medicare payment claims, saying it immunizes contractors from scrutiny and opens the door to potential fraud and abuse.

A three-judge panel said on Sept. 11 that decisions by the U.S. Department of Health and Human Services' recovery audit contractors, or RACs, to reopen Medicare claims are protected from administrative and judicial appeals by Medicare providers thanks to regulations passed in 2005,...
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