CMS recovery audit take-backs continue to rise

Take-backs achieved by the Center for Medicare & Medicaid Services' (CMS) recovery audit program continue to increase exponentially, according to recently released figures from late 2011.

CMS' Recovery Audit National Program was able to collect nearly $398 million in overpayment take-backs between October and December of last year – nearly half of the amount recovered in CMS' fiscal year 2011, which ran from October 2010 to September of last year.

"As recovery auditors escalate their reviews across healthcare organizations … these audits are greatly impacting financial performance, driving the need for providers to ensure revenue integrity," said Keith Neilson, CEO of automated revenue integrity solutions provider Craneware, in a statement. "The entire healthcare industry is looking to … ensure charge compliance and reduce payment recoupment."

Last month, CMS announced a tentative new start date for recovery audit prepayment reviews, which were postponed from their original start date of January 1. The anti-fraud programs will now be launched at the beginning of June or later in order to allow the agency to consider comments and suggestions related to recovery audits.

Leave a Reply

Your email address will not be published. Required fields are marked *

Prove You're Human * Time limit is exhausted. Please reload the CAPTCHA.