tci Medicare Compliance & Reimbursement - 2013 Issue 18

Recovery Audit Contractors: OIG Asks CMS To Take Immediate Action On Potential Fraud

RACs identify improper payments totaling over a billion dollars. The Centers for Medicare & Medicaid Services (CMS) has yet to take action on vulnerabilities identified by the recovery audit contractors (RACs) according to the OIG’s report, Medicare Recovery Audit Contractors and CMS’s Actions to Address Improper Payments, Referrals of Potential Fraud, and Performance, which the agency released last week to report on whether CMS has taken action based on previous RAC audits. Background: In fiscal years 2010 and 2011, the RACs identified half of all claims that they reviewed as involving improper payments, which totaled $1.3...

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