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.
More Articles on RACs:
CMS Caps Medical Record Reimbursement for RAC Audits
RAC “Take-Backs” Increase, Expected to Escalate More
Medicare RACs Can Now Request Twice as Many Claims
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.