Medicare RACs Recoup Record-High $657M in Third Quarter

In the third quarter of the 2012 federal fiscal year, Medicare Recovery Auditors (RACs) collected $657.2 million in overpayments — the highest total of any quarter since October 2009, according to CMS' quarterly RAC newsletter (pdf).

In the second quarter, RACs recouped $588.4 million, the previous record. Each quarter in FY 2012 has seen record-high levels of Medicare overpayment collections, and through the first three quarters, the RAC program has collected $1.64 billion.

RACs also returned $44.1 million in underpayments, lower than the $61.5 million in underpayments in the second quarter of this year. Medicare RACs have returned $130.5 million in underpayments through the first three quarters of FY 2012, meaning that for every Medicare dollar a RAC returns to a provider, it recoups $12.59 in overpayments.

HHS Regions A, B and C reported cardiovascular procedures as their top overpayment issue in the third quarter, and Region D cited minor surgery and other treatments billed as inpatient as its main overpayment issue — identical observations from the second quarter. Overpayment red flags from each region involved medical necessity review for inpatient treatment. CMS did not disclose the most common issues for underpayments.

More Articles on Medicare RACs:

7 Projects Hospital CFOs Should Focus on in the Final Months of 2012

Hospital RAC Activity Up More Than 20% From 1Q to 2Q

CMS' Medicare RACs Collect Record $588.4M in Overpayments in 2Q

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars