RACs were 'most improved' healthcare auditors for getting back money in 2013, government report states

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Medicare Recovery Audit Contractors dramatically stepped up their overpayment recoveries last year, returning nearly $487 million more to the government than they did in 2012, according to a new report from a federal watchdog agency.

The RACs “demonstrated the largest improvement” among all healthcare auditors in terms of their overpayment recoveries in fiscal year 2013, stated Thursday's report from the Department of Health and Human Service Office of the Inspector General.

However, providers were under scrutiny and returning substantial sums to Uncle Sam across the board, the report indicated. HHS recovered 88% of identified improper payments in 2013, compared with 79% a year prior.

Long-term care providers, hospitals, physicians and other groups have protested that RACs are too aggressive in flagging overpayments. Providers cite these RAC tactics as a reason for a huge backlog of appeals that have clogged the system, leading to a two-year pause of all cases at the administrative law judge level. The Centers for Medicare & Medicaid Services has temporarily halted RAC activity until a new round of auditor contracting is completed.

But Medicare auditors might cite Thursday's report as more evidence that their services are needed. While improper payment rates went down for Medicaid and most other government healthcare programs, they increased for Medicare between 2012 and 2013, according to HHS figures.

The rate increased from 8.5% to 10.1% for Medicare fee-for-service, and it jumped from 3.1% to 3.7% for the Medicare prescription drug program.

Click here to access the complete report, which focused on HHS' reporting of improper payments.

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