The Centers for Medicare & Medicaid Services (CMS) recently announced payment corrections, totaling $684.8 million. As some hospitals already are struggling with cut reimbursements, CMS this quarter collected overpayments worth $233.4 million, compared to returning $55.9 million in underpayments.
Under the Tax Relief and Health Care Act of 2006, recovery auditor contractors (RACs) identify and correct inappropriate payments. CMS released the following data this month.
|
|
FY 2010 |
FY 2011 Q1 |
FY 2011 Q2 |
FY 2011 Q3 |
Total national program |
|
Overpayments collected |
$75.4 M
|
$81.2 M |
$185.2 M |
$233.4 M |
$575.2 M |
|
Underpayments returned |
$16.9 M |
$13.1 M |
$23.7 M |
$55.9 M |
$109.6 M |
|
Total corrections |
$92.3 M |
$94.3 M |
$208.9 M |
$289.3 M |
$684.8 |
Compared to 2010 and previous quarters, the data may indicate that CMS is increasing its collection efforts, beefing up so-called "RAC attacks."
"RAC's are taking advantage of their ability to run automated reviews around the clock on much less cost than a complex review not yielding big dollars. Just because a hospital is not getting record requests, don't assume that you are not being audited and losing money," said Elizabeth Lamkin, partner, PACE Healthcare Consulting, LLC, in a Revenue Cycle Institute article.
For more information:
- read the Revenue Cycle Institute article
- check out the CMS report (.pdf)