The Centers for Medicare and Medicaid Services has released new data for the Medicare Recovery Audit Contractor program.
Through June 30, 2011, RACs collected a total of $233.4 million in overpayments and returned a total of $55.9 million in underpayments. Fiscal year to date corrections, both over- and underpayments, total $592.5 million
Overpayment collections by region include the following:
- A — $40.4 million
- B — $33.9 million
- C — $46.9 million
- D — $112.2 million
Underpayments returned by region include the following:
- A — $5 million
- B — $9.8 million
- C — $7.4 million
- D — $33.7 million
Based on collected amounts through June 17, the top issue for Region A was medical necessity for renal and urinary tract disorders. For Region B, the main issue was DRG validation for extensive operating room procedures unrelated to principal diagnosis. Region C's top issue was DMEPOS automated review for durable medical equipment, prosthetics, orthotics and supplies provided during an inpatient stay. The main issue for Region D was medical necessity for minor surgery and other treatments billed as inpatient services.
View RAC data for the third quarter, FY 2011 (pdf).
Related Articles on RACs:
Medicaid RACs Can Save Up to $10B, PRGX CEO Says
16 States With Medicaid RAC Contracts
RACs Focusing on Back, Chest Pain
Through June 30, 2011, RACs collected a total of $233.4 million in overpayments and returned a total of $55.9 million in underpayments. Fiscal year to date corrections, both over- and underpayments, total $592.5 million
Overpayment collections by region include the following:
- A — $40.4 million
- B — $33.9 million
- C — $46.9 million
- D — $112.2 million
Underpayments returned by region include the following:
- A — $5 million
- B — $9.8 million
- C — $7.4 million
- D — $33.7 million
Based on collected amounts through June 17, the top issue for Region A was medical necessity for renal and urinary tract disorders. For Region B, the main issue was DRG validation for extensive operating room procedures unrelated to principal diagnosis. Region C's top issue was DMEPOS automated review for durable medical equipment, prosthetics, orthotics and supplies provided during an inpatient stay. The main issue for Region D was medical necessity for minor surgery and other treatments billed as inpatient services.
View RAC data for the third quarter, FY 2011 (pdf).
Related Articles on RACs:
Medicaid RACs Can Save Up to $10B, PRGX CEO Says
16 States With Medicaid RAC Contracts
RACs Focusing on Back, Chest Pain