CMS Recovery Audit Contractor Demonstration Problems Left $231 Million Uncollected

OPEN MINDS Weekly News Wire Strategic Health Care News The three-year demonstration of the Medicare recovery audit contractor (RAC) program could have collected $231 million more, but during the demonstration the federal Centers for Medicare and Medicaid Services (CMS) did not address problems that led to the improper payments. Most of the uncollected $231 million was related to inpatient claims requiring complex reviews of the medical record. Although in planning for the program’s national expansion, CMS released edits to address many of the problems identified in the demonstration, a review of the RAC demonstration by the Government Accountability . . .