Region 5

Region 5 Updates

05/17/2023

The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Therefore, subsequent to the Biden Administration’s termination of the Public Health Emergency (PHE), we are resuming normal Medicare Fee-for-Service (FFS) medical review activities. Please visit the https://www.cms.gov/research-statistics-data-and-systems/monitoring-programs/medicare-ffs-compliance-programs/overview to stay up-to-date on Medicare FFS Compliance Programs, such as the RAC Program, and considerations surrounding the COVID-19 PHE.

03/01/2022

The Centers for Medicare & Medicaid Services (CMS) has modified the additional documentation request (ADR) limits for the Medicare Fee-for-Service Recovery Audit Contractor (RAC) program for suppliers. Additional information can be found on the CMS.gov website Resources | CMS

additional documentation limits for durable medical equipment suppliers (cms.gov)

Contract Key Personnel

Kevin Moyer

Kevin Moyer

Program Manager

Kevin Moyer is responsible for the National Region 5 DMEPOS, Home Health, and Hospice Recovery Audit Contract (RAC) program. Kevin has over 20 years of senior leadership experience helping organizations evolve their operational competencies. From the financial services to healthcare and medical device landscapes, he has led the part of the organization that faces outward to its stakeholders. He develops high-performing teams with an unrelenting passion for service quality. Kevin is now responsible to ensure that the performance of the National Region 5 RAC contract meets or exceeds CMS requirements; and foster value-added relationships with CMS, Healthcare Providers, and all valued stakeholders.

Dr. Brent Nelson

Dr. Brent Nelson

Contractor Medical Director - National Region 5

Dr. Brent Nelson serves as Performant Recovery’s Contractor Medical Director for CMS’ national RAC Region 5 for DMEPOS, Home Health and Hospice, bringing with him more than 18 years of clinical and regulatory experience. Prior to Performant, he worked as the Medical Director for Utilization Management/Review, Prior Authorization and Appeals with Humana. During his tenure with Humana, Dr. Nelson worked on the team that was responsible for reviewing and rendering determinations on front end reviews, waivers, pre-authorizations and provider disputes. He began his career as an urgent care and primary care physician before transitioning out of clinical practice. Dr. Nelson received his Bachelor of Natural Sciences in Chemistry from Mesa State College and his Doctor of Osteopathy from Kirksville College of Osteopathic Medicine. He is a board-certified physician in family medicine.

Contact Us

Performant Customer Service
P.O. Box 3568
San Angelo, TX 76902
info@performantrac.com
Toll Free: (866) 201-0580

Hours:
8:00am – 4:30pm (EST)
8:00am – 4:30pm (CST)
8:00am – 4:30pm (MST)
8:00am – 4:30pm (PST)

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CMS RAC

A distinction of Performant’s services is our commitment to provider outreach on behalf of our health plan clients.

CMS RAC

A distinction of Performant’s services is our commitment to provider outreach on behalf of our health plan clients.