Surviving the RAC
The three-year Recovery Audit Contractors (RAC) Demonstration Project ended in March 2008 and resulted in tremendous financial success for CMS, the Medicare Trust Fund and the Recovery Audit Contractors who were paid on a contingency basis for identification of improper payments. As of March 27, 2008, more than $1.03 billion in improper Medicare payments were corrected. Approximately 96 percent – a whopping $992.7 million – of the improper payments were overpayments collected from providers, while the remaining 4 percent – $37.8 million – were underpayments repaid to providers. Most overpayments – about 85 percent – were collected from inpatient hospital providers when the providers submitted claims that did not comply with Medicare’s coding or medical necessity policies. Could your hospital be at risk of having its Medicare payments taken back by the RAC?
