CMS releases recovery audit program report

According to the first Centers for Medicare & Medicaid Services report to Congress on the National Recovery Audit program, $175 million in Medicare overpayments and nearly $17 million in underpayments were corrected by the government in fiscal year 2010, FierceHealthcare reports.

The program was launched on a nationwide scale at the beginning of 2010, with the aim of overseeing the almost one billion claims submitted by more than one million providers annually, including hospitals, ambulance companies, and skilled nursing facilities.

In its first year, RACs corrected more than $92 million worth of improper payments. Of that amount, 82 percent were overpayments while 18 percent were underpayments.

According to the report, the most common payment errors were due to incorrect coding, lack of documentation, and billing for items or services not covered by Medicare.

A report released in July identified the top issues between March and June as input of unrelated principal diagnosis and procedure codes for an inpatient claim, incorrectly billing minor surgery and other treatments as inpatient, and billing for bundled services separately. 

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