During the second quarter of the federal government's 2012 fiscal year, the Medicare Recovery Audit Program collected $588.4 million in overpayments — the most overpayment dollars the RAC program has collected in its existence thus far, according to CMS' quarterly RAC newsletter (pdf).
RACs also returned $61.5 million in underpayments, as the total quarter RAC corrections equaled $649.9 million. So far in FY 2012 (Oct. 1, 2011, through March 31, 2012), RACs have collected $986.2 million in overpayments and have returned $86.4 million in underpayments.
HHS Regions A, B and C reported cardiovascular procedures as their top overpayment issue in the second quarter, and Region D cited minor surgery and other treatments billed as inpatient as its main overpayment issue. Those overpayment red flags involved medical necessity review for inpatient treatment. CMS did not disclose the most common issues for underpayments.
Last week, the American Hospital Association released its most recent RACTrac Survey, which quantifies hospitals' interactions with RACs. Hospitals said they appealed roughly one-third of all RAC denials, and 75 percent were overturned in favor of the hospital.
RACs also returned $61.5 million in underpayments, as the total quarter RAC corrections equaled $649.9 million. So far in FY 2012 (Oct. 1, 2011, through March 31, 2012), RACs have collected $986.2 million in overpayments and have returned $86.4 million in underpayments.
HHS Regions A, B and C reported cardiovascular procedures as their top overpayment issue in the second quarter, and Region D cited minor surgery and other treatments billed as inpatient as its main overpayment issue. Those overpayment red flags involved medical necessity review for inpatient treatment. CMS did not disclose the most common issues for underpayments.
Last week, the American Hospital Association released its most recent RACTrac Survey, which quantifies hospitals' interactions with RACs. Hospitals said they appealed roughly one-third of all RAC denials, and 75 percent were overturned in favor of the hospital.
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