In its most recent update of recovery audit contractor (RAC) appeals, the Centers for Medicare & Medicaid Services (CMS) reported that the RAC demonstration program has corrected more than $1.03 billion of Medicare improper payments. Approximately 96 percent of those payments were overpayments collected from providers; the remaining 4 percent were underpayments repaid to providers.
From the inception of the RAC demonstration through June 30, 2008, providers appealed only 19.6 percent (102,705) of the RAC determinations; of those appealed, 34.9 percent (35,819) were decided in the provider’s favor.
As of June 30, there are an additional 1,607 claims (valued at $12 million) pending. Access the report.
