RAC UPDATE: Contingency fees announced
Patient Financial Services Weekly Advisor, October 17, 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.
PRG denied contract
CMS said it chose not to select PRG-Schultz (PRG), which had the lowest percentage of appeals overturned in the demonstration project (2.1%). CMS had awarded PRG the California contract. In a press release, PRG said it received one of the highest technical scores but was denied a permanent contract because of its high contingency fee bid.
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