Profit at HMS Holdings, one of the largest companies in CMS' Recovery Audit Program for both Medicare and Medicaid, plummeted 28 percent, from $9.82 million in the first quarter of 2011 to $7.04 million in the first quarter of 2012.
Medicare RACs fueled the net income. Last year, HMS bought HealthDataInsights, the Medicare RAC for CMS Region D, for $400 million, and HMS CEO Bill Lucia said HDI exceeded the Medicare RAC revenue targets for the first quarter.
However, there was more uncertainty on the Medicaid side. "Our Medicaid business was impacted by temporary challenges faced by our clients and carriers in adopting several new CMS-mandated claim transaction formats," Mr. Lucia said in the news release. "And while [HMS] continued to win a market-leading share of Medicaid RAC business, uncertainty surrounding the Supreme Court's review of the [Patient Protection and] Affordable Care Act contributed to further delays in state decision-making relating to RAC procurements, awards and implementations."
Total revenue increased by 30.1 percent year-over-year, from $82.5 million to $107.3 million.
Medicare RACs fueled the net income. Last year, HMS bought HealthDataInsights, the Medicare RAC for CMS Region D, for $400 million, and HMS CEO Bill Lucia said HDI exceeded the Medicare RAC revenue targets for the first quarter.
However, there was more uncertainty on the Medicaid side. "Our Medicaid business was impacted by temporary challenges faced by our clients and carriers in adopting several new CMS-mandated claim transaction formats," Mr. Lucia said in the news release. "And while [HMS] continued to win a market-leading share of Medicaid RAC business, uncertainty surrounding the Supreme Court's review of the [Patient Protection and] Affordable Care Act contributed to further delays in state decision-making relating to RAC procurements, awards and implementations."
Total revenue increased by 30.1 percent year-over-year, from $82.5 million to $107.3 million.
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