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Category : Press Release

CMI Urges Congress to Mandate Medicare RAC Pre-Pay Claim Reviews

  CMI Urges Congress to Mandate Medicare RAC Pre-Pay Claim Reviews Leveraging expertise of recovery auditors could prevent billions lost to improper billing Washington, D.C. – Today, the Council for Medicare Integrity (CMI) asked Members of Congress to champion the authorization of a prepayment Recovery Audit Contractor (RAC) Program to review Medicare Fee-For-Service (FFS) claims before they are paid to identify errors and prevent tens of billions in improper payments from draining from the program each year. Medicare loses more […]

Medicare Improper Payments Remain Above Legal Threshold Four Years in A Row

  FOR IMMEDIATE RELEASE February 1, 2017         CONTACT: Kristin Walter kristin.walter@gowestfourth.com (202) 898-0995 Medicare Improper Payments Remain Above Legal Threshold Four Years in A Row  Washington, D.C. – The Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Error Rate Testing (CERT) program has released a new report detailing the FY2016 Medicare Fee-For-Service (FFS) billing error rate – which landed at 11 percent and equates to a loss of $41.1 billion from Medicare in a single year. Evaluating a statistically valid random sample […]

Top 10 States with Highest Medicare Waste

FOR IMMEDIATE RELEASE January 18, 2017 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Top 10 States with Highest Medicare Waste Waste Chief Reason Medicare Predicted to be Bankrupt by 2028  Washington, D.C. – The Council for Medicare Integrity (CMI) today released an analysis of improper payments made within the Medicare Fee-For-Service (FFS) program. The analysis looks at the amount of Medicare overpayments collected from providers by Recovery Audit Contractors in each state in FY2015 and crosses that data with the number […]

Abbott Northwestern Hospital Overbilled Medicare By $8 Million

FOR IMMEDIATE RELEASE January 5, 2017    CONTACT: Kristin Walter kristin.walter@gowestfourth.com (202) 898-0995   Abbott Northwestern Hospital Overbilled Medicare By $8 Million Washington, D.C. – A January 2017 report by the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Abbot Northwestern Hospital in Minneapolis, Minn., overbilled Medicare in 47 percent of billing claims, resulting in $8,038,356 in overpayments from 2013 to 2014.  According to the Council for Medicare Integrity, a nonprofit organization that advocates for […]

FY2015 RAC Report to Congress: Recoveries Decline Due to Program Pause

FOR IMMEDIATE RELEASE December 12, 2016 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 FY2015 RAC Report to Congress: Recoveries Decline Due to Program Pause New RAC Contract Awards Jumpstart Reviews in FY2016 Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) have released the Medicare fee-for-service Recovery Audit Program’s annual report to Congress for the fiscal year 2015. The report shares that Recovery Audit Contractors (RACs) identified 618,966 claims with improper payments resulting in $440.69 million in improper payments […]

HHS: Recovery Auditors Not Responsible for Medicare Appeals Backlog

FOR IMMEDIATE RELEASE November 17, 2016 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 HHS: Recovery Auditors Not Responsible for Medicare Appeals Backlog Only 9.5% of Appeals Related to Recovery Audit Determinations Washington, D.C.  – The U.S. Department of Health and Human Services (HHS) last week released a brief sharing new data that demonstrates that the RAC “program simply was not, and is not, the primary source of the [Medicare appeals] backlog.” Refuting claims by the hospital industry that the Recovery Audit […]

RAC Facts: HHS: RACs Are Not Responsible for Appeals Backlog, Only 9.5% of Appeals

HHS: RACs Are Not Responsible for Appeals Backlog, Only 9.5% of Appeals Recently, the U.S. Department of Health and Human Services (HHS) issued a response to discussions about the Medicare appeals backlog, releasing new data on what is causing the backlog and what actions are being taken to reduce it. HHS determined that the RAC “program simply was not, and is not, the primary source of the backlog”; That RAC-related appeals made up only 9.5% of all appeals filed with […]

Council for Medicare Integrity Urges Congress to Pass AFIRM Act

Council for Medicare Integrity Urges Congress to Pass AFIRM Act Reform Needed to Repair Besieged Medicare Appeals Process Washington, D.C. – Today, the Council for Medicare Integrity (CMI) is asking Members of Congress to take swift action to pass the Audit and Appeals Fairness, Integrity and Reforms in Medicare (AFIRM) Act. Passed by the Senate Finance Committee last year, AFIRM seeks to make urgently needed programmatic changes to help address the backlog of 560,663 cases waiting for review in the […]

CMS Awards New Recovery Audit Contracts

FOR IMMEDIATE RELEASE November 1, 2016  CONTACT: Kristin Walter kristin.walter@gowestfourth.com (202) 898-0995 CMS Awards New Recovery Audit Contracts Demonstrates Federal Government Commitment to Reducing Improper Payments in Medicare  Washington, D.C. – Today, The Centers for Medicare and Medicaid Services (CMS) moved forward to award the second round of the national Recovery Audit Contractor (RAC) program contracts, extending the vital program that identifies and returns Medicare improper payments back to the Trust Funds. Five new contracts have been awarded – four regional contracts […]

OIG Report: Home Health VNA Overbilled Medicare By $15.5 million

FOR IMMEDIATE RELEASE  CONTACT: Kristin Walterkristin.walter@gowestfourth.com(202) 898-0995 OIG Report: Home Health VNA Overbilled Medicare By $15.5 million Washington, D.C. – A report released this week by the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Home Health VNA in Lawrence, Mass., overbilled Medicare $15,483,448 million from 2011 to 2012.  According to the OIG, 21 percent of the hospital’s Medicare claims were improperly billed. According to the Council for Medicare Integrity, a nonprofit organization that advocates for proper Medicare […]