May / June 2009

Recovery Audit Contractors (RAC) —
What They Mean for You

According to the Centers for Medicare & Medicaid Services (CMS), the next steps have been taken in the agency's comprehensive efforts to identify improper Medicare payments and fight fraud, waste, and abuse in the Medicare program by awarding contracts to four permanent Recovery Audit Contractors (RACs) designed to guard the Medicare Trust Fund.

In the Tax Relief and Health Care Act of 2006, Congress required a permanent and national RAC program to be in place by January 1, 2010. The national RAC program is the outgrowth of a successful demonstration program that used RACs to identify Medicare overpayments and underpayments to health care providers and suppliers in California, Florida, New York, Massachusetts, South Carolina, and Arizona. The demonstration resulted in over $900 million in overpayments being returned to the Medicare Trust Fund between 2005 and 2008 and nearly $38 million in underpayments returned to health care providers.

The goal of the recovery audit program is to identify improper payments made on claims of health care services provided to Medicare beneficiaries. Improper payments may be overpayments or underpayments.

Learn more in ABQAURP's upcoming Webinar to be hosted in Spring 2009.
Watch the website for details!

Is Your Medical Education Accredited?

ABQAURP welcomes applications for joint sponsorship of educational activities for continuing education credit. ABQAURP accredits a variety of activities, including:

ABQAURP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians and is also accredited by the Florida Board of Nursing to sponsor nursing contact hours. As an accredited provider, ABQAURP is here to work with each joint sponsor organization to ensure the accreditation process runs as smoothly as possible. Benefits of working with ABQAURP include: one-on-one assistance, on-site assistance, contact for speakers and commercial supporters, evaluation compilation, website placement, and advertising in the Patient Safety & Quality Healthcare magazine.

ABQAURP believes that ongoing continuing education in new research, identified problem areas in clinical practice, and areas of interest in the quality assurance, utilization review, risk management, and managed care fields is a worthy endeavor to pursue. Participants improve the efficiency, effectiveness, and quality of health care delivered to the patients to improve the overall clinical outcome. Plus, each activity encourages participants to put into practice knowledge learned and assess the impact. Innovative courses provide important updates and practical tools for all health care professionals. These activities ensure that participating health care professionals receive up-to-date information on the ever-changing health care environment.

For more information, please call
Greg Zeaman at (800) 998-6030, ext. 118.

2009 "Recruit a Member" Drive

Advance a Colleague's Career and Help Strengthen Your Organization

A strong membership foundation ensures a strong association! As a Diplomate or AIHQ Member, you are ABQAURP's strongest and most valuable resource. Your involvement in this year's membership development campaign plays an essential role in ensuring the vitality of our organization.

ABQAURP will be rewarding the member who recruits the largest number of new members with a $500 VISA gift card plus a Member Spotlight on the home page of ABQAURP's website. In addition, Diplomates and AIHQ Members continue to earn a $25 credit for each referred individual who converts to an AIHQ or Corporate Member or sits for the HCQM Certification Exam by December 31, 2009. This credit may then be used toward membership fees, publication purchases, or conference registrations. The top recruiter will be awarded the prize in January 2010. Visit www.abqaurp.org and go to the "Member's Only" page for eligibility rules and full details.

Want to be featured in Patient Safety and Quality Healthcare? ABQAURP wants to recognize members for their achievements in advancing the field of health care quality management and patient safety. Please send your news to ABQAURP by email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it for consideration.