Medicare collected a total of $797.4 million in overpayments for fiscal year 2011, compared to returning $141.9 million in underpayments, according to a new report from the Centers for Medicare & Medicaid Services (CMS).
According to the report, Medicare Recovery Audit Contractors (RAC) also made payment corrections totaling $939.4 million this year, almost 10 times more than the $92.3 million in fiscal year 2010.
CMS released the following data this month.
|
|
FY 2011 Q1 |
FY 2011 Q2 |
FY 2011 Q3 |
FY 2011 Q4 |
Total national program |
|
Overpayments collected |
$82.9M
|
$187.4M |
$250.0M |
$277.1M |
$797.4M |
|
Underpayments returned |
$9.6M |
$14.8M |
$41.0 M |
$76.6M |
$141.9M |
|
Total corrections |
$92.4M |
$202.2M |
$291.0 M |
$353.7M |
$939.4M |
RACs' ability to adequately identify and correct inappropriate payments may get a boost in 2012, thanks to the Department of Health & Human Services Office of Inspector General's (OIG) embracing data-mining technology, according to a BNA article today.
"Using data mining and computer matching, the OIG will review hospitals that have the most risk [of overpayments]. During the reviews, hospital executives might be interviewed about their compliance practices," Francis J. Serbaroli, an attorney with Greenberg Traurig LLP in New York said, the article notes.
RACs also will utilize the data-mining techniques to detect which hospitals have the least risk of overpayments so that the OIG can develop compliance best practices for Medicare billing.
For more information:
- here's the CMS report (.pdf)
- read the BNA article