FOR IMMEDIATE RELEASE

Wexford, PA. — March 3, 2009 — Compliance Concepts, Inc. (CCI) expands their existing healthcare compliance consulting services to include Recovery Audit Contractor (RAC) and Risk Assessment Data Validation (RADV) assistance. Through a partnership with Cura Software Solutions®, CCI has developed an exclusive RAC management module - “RxRAC” - to assist providers in managing the volumes and complexities of RAC audits.

CCI was established over a decade ago with a mission to assist healthcare providers nationwide in achieving, ensuring and demonstrating continued compliance with the myriad laws, rules and regulations that impact the industry on a daily basis.

As CMS mandates multiple avenues to identify potential overpayments, such as through the RAC audits, CCI is prepared to assist providers in coding, billing and medical necessity reviews.  Providers should begin self-audits as soon as possible to decrease their potential denials and ensure continued compliance with applicable rules and regulations.  And once a RAC audit is initiated, providers will be required to perform quick and thorough assessments of selected encounters, and determine appropriate resolution strategies.  CCI’s team of experts, which consists exclusively of seasoned professionals with over 15 years of healthcare experience, can assist hospitals, physicians and all providers in managing and surviving RAC audits.

The CMS RAC demonstration project took place in five states and ended in March 2008. This external audit program, designed to identify underpayments and overpayments to providers and suppliers, will become permanent and will be expanded to all 50 states by 2010. CMS just recently announced that the temporary suspension of the RAC program has been lifted, and that the expanded RAC audits will soon be underway.

Since the completion of the RADV pilot program, CMS has started implementing additional RADV audits to analyze if differences in coding between Medicare Advantage (MA) plans and Fee – For – Services (FFS) providers are the result of coding patterns or of underlying beneficiary health status.  “CMS is announcing a new audit initiative to determine the accuracy of the diagnosis code information submitted to CMS by MA plans. CMS will audit the medical records from a sample of plans including those with high, medium, and low risk score differences.  As errors of coding are identified, CMS will reconcile payments to correct for these errors at the plan level. The results of these audits will also help CMS to establish whether differences in risk scores between MA plans and FFS Medicare are attributable to differences in coding patterns, and therefore, to determine whether an adjustment to rates would be appropriate for 2010” - per CMS website: www.cms.hhs.gov.

For more information contact Donna Wilson at dwilson@ccius.com for RAC assistance, Lyn Chew at lchew@ccius.com for RADV assistance, or sales@ccius.com for general information on any of our services.

About Compliance Concepts, Inc.

Compliance Concepts, Inc. (CCI), incorporated in July 1997, was established to help organizations create a controlled environment that reinforces the commitment of the organization to compliance and provide a framework for compliance which reduces the likelihood of errors or situations of non-compliance.

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