When we announced earlier this week that the RAC organizations are the Healthcare Bounty Hunters, some folks had some obvious questions. There were the naysayers, the doubters and of course the believers.
The first question was: “Are ya’ll for real?”
At first we didn’t take this question seriously, but after it was brought to the attention of our Healthcare Bounty Hunter Slayer Commmittee (HBHSC), we decided to come clean. As truth is normally stranger than fiction, here is the report that lead to the recent Memo to Departments from the Office of the President that made the news as the ‘Bounty Hunter Directive’. We have also loaded this same HHS OIG report onto our website for posterity’s sake. You can see it here.
Now onto question #2. We received another great question from a reader asking about the Healthcare Bounty Hunter™ and the question was: “Yes, but for how long?” Obviously they are asking about how long is the Healthcare Bounty Hunter program going to be in place!
Let’s try to answer this, so here goes:
CMS has provided discussion and ‘training’ to the contractors.
The original RAC mandate did not task the contractors to report fraud, the mandate was just to identify overpayments and recoup the money. With the recent ‘Bounty Hunter‘ talk – the contractors will NOW conduct RAC Audits and then the RAC contractor will be incentivized to report fraud. Here’s the rub…By recovering funds through the RAC process, the contractors would have to do all the work and then realize a 9 – 12 % amount – now, instead of taking a measly 9 – 12% via a RAC audit, the RAC contractor by being a fraud whistle blower would receive 33-1/3% of the recovered funds and they would do none of the work – the office of the Health & Human Services (HHS) Office of Inspector General (OIG) does the work.
Voila! Let someone else do the work and get a huge check…..it’s the new American Dream but we digress.
Back to the subject at hand and to the question of: “Yes, but for how long?”
Since the RAC is now a permanent program as mandated to be in place by January 2010 via the Recovery Act of 2009 – therefore, until the law is changed, the RAC will be around and their ‘fraud reporting‘ function is now a real problem for providers. And the governments agent HCBH:1, healthcare bounty hunters are on the prowl.
Our recommendation: This HHS OIG report on healthcare bounty hunters™ might be something that you may consider putting in a package that you give to your providers.
This information piece brought to you by iTotal Solutions Healthcare Bounty Hunter Slayer™, code name HBHS-007.
