HMS and OMIG Collaboration with Provider Results in $3.1 Million RAC Recoveries
, a wholly owned subsidiary of (NASDAQ:HMSY), announced today that it has achieved $3.1 million in Medicaid Recovery Audit Contractor (RAC) recoveries through collaboration with New York State’s Office of the Medicaid Inspector General (OMIG) and a corporate provider.
Using a process that compares commercial carrier paid claim data to Medicaid paid claim records, HMS identified a potential systemic issue with Medicaid billings within one of the provider’s facilities. then worked with the corporate provider to identify the affected claims at all of the provider’s stores. After engaging in a targeted self-review of their secondary and tertiary billings to Medicaid over the prior three years, the provider ultimately identified over 350,000 incorrectly billed prescriptions across the company’s 758 New York facilities.
“This is the largest single finding that and OMIG have identified since was designated as the State’s Recovery Audit Contractor in April 2011. It demonstrates the value and effectiveness of the collaborative approach that HMS takes with our clients and providers,” said Maria Perrin, ’s Chief Business Officer.
has performed and services on behalf of New York since 2002. During that time, HMS has recovered over $1 billion on behalf of New York Medicaid and has generated billions more in savings.
is the nation's leader in and services for healthcare payers. 's clients include in more than 40 states; commercial programs, including , , and over 135 ; the Centers for Medicare and Medicaid Services (CMS); and . As a result of the company's services, clients recovered over $2.5 billion in 2011, and saved nearly $7 billion through the prevention of erroneous payments.