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Recovery Audit Contractor
The Recovery Audit Contractor, or RAC, program was created through the Medicare Modernization Act of 2003 (MMA) to identify and recover improper Medicare payments paid to healthcare providers under fee-for-service (FFS) Medicare plans. The United States Department of Health and Human Services (DHHS) is required by law to make the program permanent for all states by January 1, 2010, under section 302 of the Tax Relief and Health Care Act of 2006. History In section 306 of the Medicare Modernization Act of 2003, the United States Congress directed the DHHS to conduct a three-year demonstration program to detect and correct improper payments in the Medicare FFS program. DHHS, through its Centers for Medicare and Medicaid Services (CMS) branch, began the program in 2005, using Recovery Audit Contractors to perform the actual work of reviewing, auditing, and identifying improper Medicare payments. At the inception of the program, it focused on Medicare payments in the states of Cali ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare (United States), Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in United States Congress, Congress by a close margin. Prescription drug benefits The MMA's most touted feature is the introduction of an entitlement benefit for prescription drugs, through tax breaks and subsidies. In the years since Medicare's creation in 1965, the role of prescription drugs in patient care has significantly increased. As new and expensive drugs have come into use, patients, particularly senior citizens at whom Medicare was targeted, have found prescriptions harder to afford. The MMA was designed to address this problem. The benefit is funded in a complex way, reflecting diverse prioritie ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Diversified Collection Services
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Diversification may refer to: Biology and agriculture * Genetic divergence, emergence of subpopulations that have accumulated independent genetic changes * Agricultural diversification involves the re-allocation of some of a farm's resources to new products or non-agricultural activities Economics and finance * Diversification (finance) involves spreading investments * Diversification (marketing strategy) is a corporate strategy to increase market penetration * Diversification of firms through mergers and acquisitions Other uses * Diversified technique, a chiropractic method See also * Diversity (other) Diversity, diversify, or diverse may refer to: Business *Diversity (business), the inclusion of people of different identities (ethnicity, gender, age) in the workforce *Diversity marketing, marketing communication targeting diverse customers * ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Strategic Health Solutions
Strategy (from Greek στρατηγία ''stratēgia'', "art of troop leader; office of general, command, generalship") is a general plan to achieve one or more long-term or overall goals under conditions of uncertainty. In the sense of the "art of the general", which included several subsets of skills including military tactics, siegecraft, logistics etc., the term came into use in the 6th century C.E. in Eastern Roman terminology, and was translated into Western vernacular languages only in the 18th century. From then until the 20th century, the word "strategy" came to denote "a comprehensive way to try to pursue political ends, including the threat or actual use of force, in a dialectic of wills" in a military conflict, in which both adversaries interact. Strategy is important because the resources available to achieve goals are usually limited. Strategy generally involves setting goals and priorities, determining actions to achieve the goals, and mobilizing resources to execu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
PRG Shultz
PRG can mean: * Parti radical de gauche (Radical Party of the Left), France * Paul Roos Gymnasium, school in Stellenbosch, South Africa * Post/Redirect/Get, in web applications * prg, ISO 639-3 language code for the Old Prussian language * Václav Havel Airport Prague, IATA code * Programming Research Group, Oxford University 1965-2011 * Provisional Revolutionary Government of the Republic of South Vietnam, Viet Cong party * People's Revolutionary Government (Grenada) * Pseudorandom generator In theoretical computer science and cryptography, a pseudorandom generator (PRG) for a class of statistical tests is a deterministic procedure that maps a random seed to a longer pseudorandom string such that no statistical test in the class ca ..., of deterministic but pseudorandom numbers * .prg is a file format used for Commodore 64 software {{disambig ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Connolly, Inc
Connolly, LLC (formerly Connolly, Inc.) is a private, global-recovery audit firm with more than 1,200 employees, and two divisions Global Retail and Healthcare. The company is headquartered in Wilton, Connecticut. Recovery Auditing Recovery auditing involves recouping the money that companies and government agencies have erroneously paid to suppliers, vendors, and providers. These errors can include duplicate payments, missed discounts, and incorrectly coded medical claims. These types of improper payments are endemic to most large organizations and can range from less than 1% to as much as 8% of expenditures. History Connolly was founded in 1979 by James Connolly, a former executive at the Gimbels department store, and was initially known as Connolly Consulting Associates. The company’s initial focus was on retailers, but the business was expanded to non-retailers in the early 1990s, and to healthcare medical claims auditing in the late 1990s. Larry Connolly assumed leader ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
CGI Group
CGI Inc. is a Canadian multinational information technology consulting and systems integration company headquartered in Montreal, Quebec, Canada. CGI has a market value of $21.8 billion, making it one of the top 30 companies in Canada. The company went public in 1986 with a primary listing on the Toronto Stock Exchange. CGI is also a constituent of the S&P/TSX 60 and has a secondary listing on the New York Stock Exchange. As of 2022 CGI is based in forty countries with around 400 offices and employs approximately 88,000 people. Services provided by CGI as of 2018 include application services, business consulting, business process services, IT infrastructure services, IT outsourcing services, and systems integration services, among others. CGI has customers in a wide array of industries and markets, with many in financial services. History 1970s-1980s: Early years CGI Inc. was founded as an IT consulting company on June 15, 1976, in Quebec City, Québec, by Serge God ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Recovery Auditing
Recovery auditing is the systematic process of reviewing disbursement transactions and the related supporting data to identify and recover various forms of over payments and under-deductions to suppliers. In other words, it is the recovery of lost money. History Recovery auditing was at first primarily for retail based companies. It was developed in the 1970s as a result of companies losing millions of dollars annually because of unpaid invoices, duplicate payments, discounts and allowances not received and general overpayments. Before recovery auditing, this "lost money" was too difficult to identify due to the large amount of transactions processed every year. Companies began investigating deeper into their accounting and found errors in their favor. T In the United States, two of the largest contributions made by this industry was the Improper Payments Act of 2002 (IPIA) spearheaded by Paul Dinkins and the Medicare Modernization Act of 2003. Types of Recovery Audit Services * A ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare (United States)
Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). In 2018, according to the 2019 Medicare Trustees Report, Medicare provided health insurance for over 59.9 million individuals—more than 52 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by the government's MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees almost always cover most of the remaining costs by taking additional private insurance and/or by joining a public Part C or P ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Centers For Medicare And Medicaid Services
The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaini ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
United States Congress
The United States Congress is the legislature of the federal government of the United States. It is bicameral, composed of a lower body, the House of Representatives, and an upper body, the Senate. It meets in the U.S. Capitol in Washington, D.C. Senators and representatives are chosen through direct election, though vacancies in the Senate may be filled by a governor's appointment. Congress has 535 voting members: 100 senators and 435 representatives. The U.S. vice president has a vote in the Senate only when senators are evenly divided. The House of Representatives has six non-voting members. The sitting of a Congress is for a two-year term, at present, beginning every other January. Elections are held every even-numbered year on Election Day. The members of the House of Representatives are elected for the two-year term of a Congress. The Reapportionment Act of 1929 establishes that there be 435 representatives and the Uniform Congressional Redistricting Act requires ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
