Revenue Cycle

RAC UPDATE: Contingency fees announced

Patient Access Weekly Advisor, October 15, 2008

CMS announced the new Medicare Recovery Audit Contractors (RACs) for its permanent nationwide program last week.

Now we know how much they’ll make off their takebacks from provider overpayments.

The contingency fees breakdown is as follows:

  • Region A: 12.45%
  • Region B: 12.50%
  • Region C: 9%
  • Region D: 9.49%

The four contractors and their selected regions are:

  • Diversified Collection Services, Inc. of Livermore, CA: Region A, initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and New York.
  • CGI Technologies and Solutions, Inc. of Fairfax, VA: Region B, initially working in Michigan, Indiana and Minnesota.
  • Connolly Consulting Associates, Inc. of Wilton, CT: Region C, initially working in South Carolina, Florida, Colorado and New Mexico.
  • HealthDataInsights (HDI), Inc. of Las Vegas, NV: Region D, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona.

Connolly and HDI worked on the initial RAC demonstration project that spanned over six states, collected more than $900 million in overpayments, and returned nearly $38 million in underpayments to healthcare providers, according to a CMS press release.

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