RAC Contractors to be Identified
Posted on July 19, 2008 by Executive-Post
CMS Aims to Reduce Fraud
Staff Writers
This month, the Centers for Medicare and Medicaid Services [CMS] will name the auditing firms that will review hospitals’ books for payment mistakes, while hospital officials say results in other states suggest the auditors will give priority to recovering overpayments.
The RAC Program
Under the so-called Recovery Asset Contractor [RAC] program, CMS pays auditors a fee based on the amount of improper payments discovered.
Hospital officials worry this “bounty hunter” approach - the second for CMS after medical practice audits - will create a bias in auditors to focus only on collecting government overpayments, reported the Pittsburgh Business Times on June 16, 2008.
Pilot Program Results
Some hospitals point to a pilot audit program in New York, Florida and California, which found $357.2 million in overpayments and just $14.3 million in underpayments. Medicare estimates its error rate at 3.9 percent in 2007, down from 9.8 percent in 2003, but still totaling $10.8 billion in improper payments
Conclusion
Your thoughts and comments are appreciated. Is this another instance of brute intimidation or just honest review
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