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CMS Awards New Round of Medicare Recovery Audit Support Contracts

patient care health recordThe Centers for Medicare and Medicaid Services has awarded contracts to Performant Recovery, Cotiviti and HMS Federal Solutions to conduct assessments across five U.S. regions in support of the Medicare Fee-for-Service Recovery Audit Program.

The Medicare FFS Recovery Audit Program seeks to detect and correct overpayments and underpayments to healthcare providers through the use of recovery audit contractors.

CMS started the program in 2005 as a three-year demonstration in compliance with the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

CMS said Monday Performant Recovery will perform post-payment review in regions 1 and 5, while Cotiviti will conduct assessments in regions 2 and 3 and HMS Federal Solutions in region 4.

RACs assigned in regions 1 to 4 will carry out post-payment reviews to identify and rectify improper payments for claims paid under Medicare Part A and B.

Performant Recovery will perform post-payment evaluation of claims nationwide related to home health/hospice services and durable medical equipment, prosthetics, orthotics and supplies as an RAC in region 5.

RACs have recovered approximately $8 billion in improper payments since the program started in 2009, according to CMS data.

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