![\"\"](\"https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/09\/RAP.png\")
<\/p>\n<\/p>\n
Will you stick out like a sore thumb?<\/em><\/strong><\/span><\/p>\n You\u2019d better rein in any sloppy RAP practices you\u2019ve slid into, or you could get caught up in Medicare\u2019s crackdown on Request for Anticipated Payment abuse.<\/p>\n Why?<\/span>\u00a0<\/strong>A new Medicare transmittal issues \u201cinstructions to the Medicare Administrative Contractors \u2026 on the responsibilities to monitor home health agencies misuse of RAPs,\u201d it says. Change Request 10789 details \u201csteps regarding education, corrective action plans, as well as suppression of RAPs.\u201d<\/p>\n MACs should \u201cidentify instances where a Home Health Agency\u2019s (HHA) use of RAPs indicates potential fraud, waste or abuse,\u201d the CR says. While the\u00a0Centers for Medicare & Medicaid Services\u00a0<\/strong>acknowledges that \u201csuch instances should be rare,\u201d it notes that \u201ccorrective action includes, but is not limited to, education, warnings, Corrective Action Plans (CAPs), RAP suppression, and referrals to the Unified Program Integrity Contractor (UPIC).\u201d<\/p>\n RAP fraud and abuse isn\u2019t exactly a new target area. \u201cThe MACs have been monitoring misuse of RAPs for several years and have implemented CAPs and RAP suppression on select providers,\u201d notes the\u00a0National Association for Home Care & Hospice<\/strong>. \u201cHowever, the MACs have been enforcing appropriate\u00a0RAP submission based on their individual policies.\u201d<\/p>\n Here are shady RAP scenarios MACs will target, according to the CR:<\/p>\n What\u2019s next:<\/span>\u00a0<\/strong>When the MAC finds aberrant RAP submission patterns, it will start with education and monitoring, then may move on to corrective action \u2014 including RAP suppression.<\/p>\n The new CR puts more emphasis on the problem of RAP fraud and abuse, observers note. And it \u201cprovides standard instructions for enforcing appropriate RAP submissions,\u201d NAHC points out.<\/p>\n Up to your MAC:<\/span>\u00a0<\/strong>But the transmittal \u201cstill leaves discretion for the MACs in terms of the metrics used to identify fraud, waste, and abuse,\u201d the trade group says in its member newsletter.<\/p>\n Note: The transmittal is at\u00a0www.cms.gov\/Regulations-and-Guidance\/Guidance\/Transmittals\/2018<\/a><\/em>Downloads\/R817PI.pdf<\/a>.<\/em><\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"\n