Revenue Cycle

CMS identifies total improper payment figures; top RAC issue per region

Recovery Auditor Report, May 5, 2011

CMS released a short but useful Recovery Audit Contractor (RAC) update on its website that reports on the total amount of improper payments identified since the RAC demonstration period.

From October 2009 through the end of March 2011, RACs have identified a total of $312.2 million in overpayments and $52.6 million in underpayments, totaling $365.8 million in total improper payments. Compared to the $1.03 billion of improper payments identified in the demonstration program, these numbers are miniscule, but a significant bump last quarter illustrates that these figures will invariably grow.

The doubled amounts  ($184.6 million) reflected in the first quarter of 2011 is a true reflection of the rapid expansion of RAC audits, according to Donna D. Wilson, RHIA, CCS, CCDS, senior director at Compliance Concepts, Inc., in Wexford, PA.

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