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RAC Companies Respond to CMS Report on RAC Demonstration Program

WASHINGTON, July 11 /PRNewswire-USNewswire/ -- The following is a joint statement from HealthDataInsights, Connolly Consulting and Viant Payment Solutions offered in reaction to the release of the Centers for Medicare and Medicaid Services (CMS) report on the RAC Demonstration Program:

"The report shows that the recovery audit demonstration corrected over $1 billion in improper payments from the Medicare Trust Fund over the past three years while operating in five states. The report demonstrates that recovery auditing is an effective program to ensure proper payment of Medicare claims and to improve billing practices for the future.

"The program's accountability-based fee structure established by Congress is an industry best-practice and mirrors the methods hospitals and physicians use to collect over-due accounts. The very low rate of overturned decisions of less than 5% through all levels of appeals reflects our commitment to professionalism and demonstrates the capability of recovery audit contractors to apply Medicare policies consistently and accurately."

"We are pleased to have been part of this successful demonstration project that showed third-party recovery auditing is an efficient and effective method of correcting improper Medicare payments, improving both CMS' and provider's payment and reimbursement policies, and preserving the future integrity of the Medicare program."

According to the U.S. Department of Health and Human Services, the RAC demonstration program, created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), is designed to find and correct improper Medicare payments paid to health care providers participating in fee-for-service Medicare. Medicare processes more than 1.2 billion Medicare claims annually, submitted by more than one million health care providers, including hospitals, skilled nursing facilities, physicians and medical equipment suppliers. Errors in claims submitted by these health care providers for services provided to Medicare beneficiaries accounted for $10.8 billion in improper payments in 2007, according to the General Accounting Office.

SOURCE HDI; Connolly Consulting; Viant Payment Solutions
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