Physician Practice

New Recovery Auditor contracts announced

Physician Practice Insider, November 15, 2016

CMS has awarded five new contracts for the next round of the Recovery Audit Program, the agency announced October 31. The contracts were awarded to:

  • Region 1: Performant Recovery, Inc.
  • Region 2: Cotiviti, LLC
  • Region 3: Cotiviti, LLC
  • Region 4: HMS Federal Solutions
  • Region 5: Performant Recovery, Inc.

The base period for contracts is 12 months from the date the contract is awarded.

Recovery Auditors (RA) in Regions 1 through 4 will conduct postpayment reviews of Medicare Part A and B claims, while Region 5 RAs will review home health/hospice and durable medical equipment, prosthetic, orthotics, and supplies nationally.

The program has been a burden to providers since it was launched nationally in 2010, according to the American Hospital Association, and created a backlog of appeals at the Administrative Law Judge level. But RAs have been a boon to CMS, recouping more than $9 billion dollars in overpayments since 2010.

This article originally appeared on Medicare Compliance Watch.

Most Popular