That figure is up slightly from the second quarter of 2013, when Medicare RACs took back about $626.5 million. Through the first half of the 2014 fiscal year, Medicare RACs recouped more than $1.48 billion, an increase of 8 percent from the first half of FY 2013. CMS did not identify how much of those recoupments were tied up in the appeals process or had been successfully appealed by providers. Returned underpayments in the second quarter of this year totaled $71.5 million.
Medical necessity of cardiovascular procedures remained as the top overpayment issue for RACs. Minor surgery and other treatments billed as inpatient when they should have been billed as outpatient or observation was the other top overpayment reason. CMS did not disclose the most common issues for underpayments.
More Articles on Medicare RACs:
CMS: 5 Key Measures of Success for Medicare RACs
Medicare and Medicaid RACs in FY 2012: 8 Statistics
Rep. Jim McDermott Advocates for More RAC Accountability
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