RAC Procurement Updates - New Contracts Under Pre-Award Protest
It is almost the end of the year and no new Recovery Audit Contractors (RAC) contracts have been awarded. The Centers for Medicare & Medicaid Services (CMS) has recently posted a RAC procurement update stating that as of November 4, 2014, the new contracts for Recovery Auditor Regions 1, 2, and 4 remain under a pre-award protest, which is expected to continue into late summer of 2015. The procurement process continues for Region 3 (Part A / Part B claim reviews), which includes Florida, Tennessee, Alabama, Georgia, West Virginia, Virginia, North Carolina and South Carolina. Also, Region 5, which will be the national contract for DMEPOS and Home Health & Hospice claim reviews procurement process continues. The CMS remains hopeful that these two new contracts will be awarded before the end of this year. http://cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/Recent_Updates.html
According to the CMS, “the Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments in all 50 states.” http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/
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Read other RAC updates from the Compliance Edge blog: RAC Audit Identifies Overpayments for Billing Incorrect DME Codes; CERT Program Monitors CMS FFS Improper Payments - $36 Billion in 2013