Attorney General Eric Holder declared that Medicare RAC (Recovery Audit Contractor) audits, implemented under the Affordable Care Act, “will have a substantial impact on deterring fraud and abuse, protecting patients and the elderly from scams, and ensuring that taxpayer funds are not stolen.”
Mr. Holder, I respectfully disagree. Much of what is deemed “fraud” by the federal government is simply the average medical provider’s inability to live within the governments vague, offensive and arbitrary regulations while actually caring for patients.
The newly aggressive Medicare RAC program governed under the act continues to cause mayhem and devastation within our health care system. RAC auditors viciously target legitimate providers and demand a refund of payments earned as far back as 5 years ago. They fabricate rules and regulations in order to justify denials, recoup the money based upon these prejudicial denials and continue to ignore constitutional standards.
Coincidentally, RAC auditors are paid on a contingency basis; they get paid a percentage of denied claims. So common sense would ask: What is their incentive to approve a claim? The answer is simple: Nothing. They play by their own set of rules and make it impossible for providers to comply with a moving target. The effects: Medical service providers continue to drop Medicare beneficiaries, crucial health care professionals are handing over the keys and desperate patients are left without the necessary care.
In a recent communication I received from President Barrack Obama regarding RAC audits, he emphasized that a purpose of the Affordable Care Act is to support and promote the growth of small businesses. However, thousands of fundamental small businesses are continuously closing their doors due to the overwhelming burdens caused by RAC audits, and vital medical providers are steadily becoming nonexistent. In reality, the Affordable Care Act is successfully destroying small businesses.
RAC policies succeed in extracting money from honest health care providers and fail any sensible test of objectivity or fairness. If something isn’t done soon, the pendulum will have swung too far one way and may not swing toward the center in time to preserve our health care system as a whole.