First few Article Sentences
The Department of Health and Human Services (HHS) must implement a permanent, national Recovery Audit Contractors (RAC) program by January 1, 2010. The program is expected to be underway in Washington by August 2009, with HealthDataInsights, Inc. (HDI) assigned as the contractor.
The purpose of the RAC program according to the Center for Medicare and Medicaid Services (CMS) is to reduce improper Medicare payments through the efficient detection and collection of overpayments, including Non-Medicare Secondary Payer overpayments, the identification of underpayments and the implementation of actions that will prevent future improper payments. CMS has concluded the RAC demonstration program that began in 2005 was a cost-effective success. RACs discovered over $1 billion in improper payments, 85% recovered from hospitals, during the demonstration program at a minimal cost to the government. While RACs also identify underpayments, the demonstration program revealed that 96% of claims were overpayments. Thus, the clear focus of the program is to identify and correct Medicare fraud and abuse.