CMS should improve payment processes that allowed $231 million in overpayments identified by Recovery Audit Contractors in the three-year demonstration phase of the RAC program, according to a new report from the Government Accountability Office.
The GAO report said CMS has not yet implemented corrective actions for 60 percent of the most significant RAC-identified vulnerabilities that allowed the improper payments to hospitals and other providers.
However, GAO noted that CMS has been resolving coordination issues between the RACs and Medicare claims administration contractors, in steps such as enhancing its data warehouse and automating the claims-adjustment process.
The report added the agency also is improving its oversight of the accuracy of the RACs' claims reviews, such as establishing independent reviews by another CMS contractor.
Read the Government Accountability Office's report on Recovery Audit Contractors (pdf).