CMS sets plans for RAC contractor expansion

In an inevitable, but still widely feared, next step, CMS has taken the first steps in phasing in its Recovery Audit Contractor (RAC) program, announcing the four new contractors that will administer the program. The contractors will be responsible for auditing provider reimbursement requests to find overpayments and underpayments, with each taking about one-quarter of the country.

The contractors are Diversified Collection Services of Livermore, CA, CGI Technologies and Solutions of Fairfax, VA, Connolly Consulting Assoc. of Wilton, CT and HealthDataInsights of Las Vegas.

Medicare is moving ahead with the RAC program, initially pilot-tested in several states, after it reportedly recovered $1 billion in improper payments made since 2005, resulting in a $693.6 million to the government. HHS is required by law to make the RAC program a permanent, national one in all 50 states by Jan. 1, 2010. However, some observers--including Reps John Dingell (D-MI) and Charles Rangell (D-NY)--are concerned that the program's design still isn't fair. Expect more fireworks here in coming months. 

To learn more about CMS's plans:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
CMS: RAC program has recovered more than $1B
Readers weigh in on Medicare recovery audit program
HFMA ANI 2008: Advice on preparing for a Medicare audit
Freeze proposed on Medicare audit program

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