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Health Care Chair Paula Sanders Examines Medicare Recovery Audits for Jan. 2014 Long-Term Living

January 1, 2014

In the January 2014 issue of Long-Term Living Magazine, Health Care Chair Paula G. Sanders examines the risk of huge Medicare repayments for skilled nursing facilities (SNF) as a result of Medicare recovery audits. 

Ms. Sanders writes that, "Medicare recovery auditors (RAs), who are incentivized by contingency fees, are targeting SNF claims for residents admitted with a psychiatric diagnosis from psychiatric hospitals or units." The impact on SNFs. says Ms. Sanders, is that, "facilities that have received additional documentation requests (ADRs) for complex medical review of these claims are finding that many of their claims are subsequently and perfunctorily denied."