CMS changes who can perform complex medical review; call RACs "MRACs"

by Julia Kyles, CPC on Aug 17, 2017
The various contractors that audit Medicare claims can't hire new licensed practical nurses (LPNs) to perform complex medical review. However, LPNs who currently perform complex auditing services are safe: they can be grandfathered in, CMS announced in CMS 100-08, Change Request 10157.
The new regulation goes into effect Sept. 12.
The change request added therapists to the list of providers who may perform complex review, along with registered nurses and physicians. 
Finally, if you see the term MRAC, don't worry that it is yet another type of auditor. According to the change request, it's CMS' new acronym for recovery auditors: Medicare recovery audit contractor.
Blog Tags: MACs, RACs
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