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

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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.

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