Health Information Management

Topic: RAC demonstration recoups $992.7 million in overpayments

HIM Connection, July 22, 2008

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Medicare Recovery Audit Contractors (RAC) corrected more than $1 billion of Medicare improper payments between 2005 and March 2008, according to a June 2008 evaluation report. The report, which outlines an analysis of the three-year demonstration project, was released July 11.
 
The report indicates the following:
  • Approximately 96% of the improper payments ($992.7 million) were overpayments collected from providers
  • 4% ($37.8 million) were underpayments repaid to providers
  • Of the $1 billion in improper payment determinations, providers chose to appeal only 14% of the RAC decisions
  • Of all the RAC overpayment determinations, only 4.6% were overturned on appeal
  • The RAC program has cost only $.20 for each dollar collected
For more information, visit www.cms.hhs.gov/apps/media/press_releases.asp.



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