CMS Database Fails to Accurately Track RAC Activity

Published
  • August 14 2014, 9:39am EDT

The Centers for Medicare and Medicaid Services does not have reliable data nor provides sufficient oversight to measure and prevent payment contractors--particularly Recovery Audit Contractors--from conducting certain duplicative post-payment claims reviews.

That is the conclusion of a new Government Accountability Office report on the Medicare contractor post-payment claims review process. In the case of Recovery Audit Contractors, tasked with identifying improper payments not previously reviewed by other contractors, CMS implemented a database to track RAC activities--designed in part to prevent RACs, which conducted most of the post-payment reviews, from duplicating other contractors' reviews.

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