Health Information Management

News: Latest Recovery Auditor report sent to Congress

CDI Strategies, February 14, 2013

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Recovery Auditors (previously called Recovery Audit Contractors [RAC]) saved Medicare nearly $500 million in Fiscal year (FY) 2011, according to the latest report to Congress. That’s up from $92.3 million in combined overpayments and underpayments identified and corrected in FY 2010 (October 1, 2009–September 30, 2010).

The recent report highlights efforts which collectively identified and corrected 887,291 claims—$939.3 million dollars in improper payments being corrected ($797.4 million in overpayments, and $141.9 million in underpayments).
The FY 20II report also highlights the first year of Recovery Auditor reviews of short-stay inpatient hospital admission issues, and the focus on medical necessity of inpatient admissions. According to the report, “these admissions represent a significant portion of Medicare's FFS error rate and also represent a large portion of the FY 2011 overpayment collections.”

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