Hospitals and ambulatory surgical centers (ASCs), generally operating under Medicare Part A, have been hard hit by RAC audits. With the size and complexity of these institutions, mistakes can and often do happen, and coding or billing errors may occur. While the use of DRG codes and MDC classification is decades old, CMS has started to take a second look at the appropriateness of much of the hospital industry's DRG coding, employing Recovery Audit Contractors to examine claims and their supporting documentation. Unlike smaller providers, assessments against hospitals can quickly multiple, leading to multi-million dollar overpayment demands. It is all the more important then that a hospital effectively appeal the initial decisions made by RACs, and health law counsel experienced in appealing Medicare claims can greatly assist hospital counsel in getting the job done. To learn more about RAC audits, please visit For information on compliance initiatives and compliance training, please visit

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