CMS Awards New Recovery Audit Contracts

November 1, 2016 

CONTACT: Kristin Walter
(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 and one for a new region focused solely on auditing DME/HH-H claims nationwide. The contracts have been awarded to:

Region 1                               Performant Recovery, Inc.
Region 2                               Cotiviti, LLC
Region 3                               Cotiviti, LLC
Region 4                               HMS Federal Solutions
DME/HH-H                           Performant Recovery, Inc.

With the financial future of the Medicare program in a precarious position, it’s more important than ever for RACs to be back at work actively recovering misspent Medicare funds to extend the life of the program. Recently, Medicare Trustees raised concerns that at current spending levels, the program will be insolvent by 2028 – two years sooner than previously reported.

Congress mandated the creation of the RAC program to review Medicare claims, identify billing errors and return mis-billed funds back to the Medicare Trust Fund. Since the program began in 2009, RACs have returned more than $10 billion in improper payments to the Trust Fund and more than $800 million in underpayments to providers. Recovery auditing has been credited with extended the life of the Medicare program by two full years.

“We are pleased to see these important contracts awarded, marking the beginning of a new phase of Recovery Auditing work and demonstrating a renewed commitment to reducing improper payments in Medicare,” said Kristin Walter, spokesperson for the Council for Medicare Integrity.  “Medicare loses more money to waste than any other federal program, with a billing error rate well above the legal threshold of 10 percent for the past three years in a row. With Medicare’s solvency in serious jeopardy due to a loss of more than $150 billion in taxpayer dollars over the last three years, renewing the work of the RAC program to balance the program’s checkbook is essential to protecting Medicare’s future fiscal health. Now, auditors can to get back to the important work of reducing improper payments, which ultimately protects American seniors’ long-term access to healthcare.”

For more information, please visit: www.medicareintegrity.org. 

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About the Council for Medicare Integrity

The Council for Medicare Integrity is a 501(c)(6) non-profit organization. The Council’s mission is to educate policymakers and other stakeholders regarding the importance of healthcare integrity programs that help Medicare identify and correct improper payments.

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