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CMW News: RAC program has saved CMS almost $700 million, report says

Case Management Weekly, July 16, 2008

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Since its implementation in 2005, CMS’s recovery audit contractor program (RAC) has returned $693.6 million of improper Medicare payments to the Medicare Trust Funds, says a report issued in June by CMS. in     This number takes into account the cost of the program, the dollars repaid to health providers, and the money overturned on appeal.

The RAC is a tool CMS uses to ensure Medicare payments to providers are accurate and to reduce the amount of claims errors. Most of the errors RACs identified were due to claims that did not comply with Medicare’s coverage or coding, or involved providers billing for the same procedure multiple times.

The RAC was launched in California, Florida, New York, Massachusetts, South Carolina, and Arizona from 2005 to 2008, but will be implemented as a permanent program across the nation by Jan. 1, 2010.

Sources: Medical News Today, Centers for Medicare and Medicaid Services

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