CMS finds group to conduct recovery audits

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The Centers for Medicare & Medicaid Services has hired a contractor to conduct recovery audit functions on Medicare Part D drug plan, according to the Bureau of National Affairs.
ACLR Strategic Business Solutions will start auditing in the third quarter of 2011, according to an agency memo, and work on stopping Medicare and Medicaid fraud and false claims. CMS also plans to develop a website with additional information about the Part C and Part D Recovery Audit Contractors, BNA reported. The RAC program lets CMS hire companies that can identify and recoup overpayments, and pay back underpayments. It is currently focused only on Medicare Part A and Part B providers, but the Affordable Care Act requires CMS to expand the other two parts of Medicare Parts C and D.

The program will divide the United States into four geographic regions with each region getting its own contractor. Between October 2009 and March 2011, RAC contractors collected $313 million in overpayments and returned $52 million in underpayments to providers.