Cox Smith Announces Immediate Availability of RAC Audit Team

SAN ANTONIO--(BUSINESS WIRE)--

Cox Smith Matthews Incorporated (“Cox Smith”) today announced the immediate availability of its healthcare practice to provide counseling to companies in Texas who may be subject to a RAC review.

The Tax Relief and Health Care Act of 2006 called for the establishment of a permanent Recovery Audit Contractor (RAC) program by January 1, 2010 to identify and recover improper Medicare payments. The RACs are incentivized to perform their jobs – they receive a contingency fee based on the amount of money returned to the Medicare Trust Funds from these audits. All Medicare fee-for-service providers are subject to a RAC review, including hospitals, physicians, skilled nursing facilities, labs, ambulance companies and durable medical equipment suppliers.

“RAC auditors are in Texas and any healthcare provider that accepts Medicare funds is an audit target,” said Dan Webster, leader of Cox Smith’s healthcare practice. “In other states that have been targeted, nearly 35 percent of the improper reimbursement claims resulted from incorrect coding and another 40 percent resulted from a failure to meet medical necessity criteria. Healthcare providers need advisors who understand the processes, requirements and timetables relating to these audits, and that’s where we can help. We provide support at every stage of the RAC process, whether it’s before the Request for Records arrives, responding to the Request, or appealing the findings.”

According to Cox Smith, often the two greatest challenges of responding to a RAC request are meeting the tight deadlines and deciphering the jargon. Cox Smith’s healthcare lawyers can answer questions and provide strategic counsel that will help providers comply with the auditor’s demands in a timely manner. Cox Smith’s healthcare practice has strong regulatory experience, specifically within Medicare and Medicaid reimbursement claims. With a team of 15 lawyers, Cox Smith’s Healthcare/Life Sciences practice assists a full range of healthcare providers across Texas in business formation and counseling, transactions, general healthcare law, regulatory matters and dispute resolution. Firm clients include hospital systems and physician groups, medical device manufacturers, biomedical research institutions and a wide variety of individuals and businesses involved in the complex web of healthcare delivery in the U.S. and overseas.

Cox Smith will host a Boot Camp for healthcare industry professionals interested in learning more about RAC audits and the RAC audit process on Friday, April 16, 2010 in San Antonio. Visit www.coxsmith.com/NewsEvents for more information.

Cox Smith’s RAC Audit team is headed up by healthcare attorneys Kathy Poppitt and Catherine Greaves. Kathy, who has been recognized by Chambers USA as a leader in her field (healthcare law) and has nearly two decades of healthcare legal experience, is focused on healthcare regulatory law, healthcare litigation and administrative law. She advises providers on operational issues such as establishing PPO and HMO networks, peer review, credentialing, joint ventures and other contracting. She also represents providers of Medicaid, Medicare, and private payor reimbursed services in reimbursement matters as well as in resolution of issues involving regulatory agencies.

Catherine has more than 20 years of experience advising clients involved in all aspects of the healthcare industry. With a focus on compliance with state and federal laws related to healthcare, she counsels clients regarding Medicare, Medicaid and other governmental programs, including coverage and reimbursement issues, joint ventures, healthcare contracting, acquisitions, licensure, and certification, as well as employment and recruitment matters. Catherine also has extensive experience advising clients on matters related to federal and state healthcare fraud and abuse issues, including anti-kickback laws, physician self-referral prohibitions (Stark Law), false claims, and other sanction issues.

About Cox Smith

Cox Smith is one of the leading business law firms in Texas. From its dominant position in San Antonio with a growing presence in key markets, Cox Smith's attorneys help regional, national and international businesses with a wide variety of matters involving all aspects of business law and litigation. For more information, visit www.coxsmith.com.