RAC audits: Skilled nursing facilities accounted for miniscule portion of 2011 Medicare overpayments

Share this article:

Skilled nursing facilities accounted for only about $200,000 of $797 million in collected Medicare overpayments in 2011 identified by Recovery Audit Contractors, according to an annual audit report released Tuesday.

Inpatient claims accounted for the lion's share of collected overpayments, at more than $677 million, according to the Centers for Medicare & Medicaid Services report.

Physician, Durable Medical Equipment and “other” claim types each accounted for between roughly $33 million and $35 million in overpayments. Outpatient claims represented more than $17 million. SNFs — the only other claim type specified by the report — therefore accounted for less than 0.3% of all collected overpayments. The RACs review did not identify any underpayments to skilled nursing facilities.

RACs returned $488 million in improper payments to the Medicare Trust Fund in 2011, the report stated. The 2010 RAC audit report did not include payments returned to the trust fund. It showed a total of $75 million in collected overpayments. The 2010 report also did not specify the proportion of overpayments attributed to SNFs.

In 2012, RAC requests for medical records spiked, according to the American Hospital Association. Last March, CMS doubled the number of medical records the auditors can request.

Share this article:

More in News

ACO bill in House would waive 3-midnight requirement for skilled nursing care

Certain Accountable Care Organizations would be able to send Medicare beneficiaries to a skilled nursing facility without a prior hospital stay under a bipartisan bill recently introduced in the House of Representatives.

Increasing staff-to-patient ratios improves nurse safety, researchers find

A law setting mandatory nurse-to-patient staffing ratios has reduced the number of workplace injuries for registered nurses and licensed practical nurses in California, according to recently published findings.

Life Care Centers takes Gold in Transitions category

Life Care Centers takes Gold in Transitions category

Life Care Centers of America has won the Gold Award in the McKnight's Excellence in Technology Awards in the Transitions category.