Preparing for healthcare reform, recovery audits

Law enforcement agencies and fraud units at insurance companies are preparing for the effects of expanding healthcare coverage to currently uninsured American citizens.

The proposed expansion is expected to come into fruition in 2014, barring the overturning of President Barack Obama's Affordable Care Act by the Supreme Court. One way the legislation will bolster states' antifraud efforts is by requiring them to pair up with recovery audit contractors (RACs) who identify and recoup fraudulent Medicaid claims.

According to Mark Anderson, director of the Medicaid fraud division in the Office of the State Comptroller, his office was able to recover more than $116 million in improperly paid claims during the fiscal year that ended on June 30, 2011.

Companies in all industries can use recovery audits to identify instances of overpayment, underpayment, payments to incorrect vendors and duplicate payments on a smaller scale. Technology Insight's Accounts Payable Recovery Audit Services can help with this process by facilitating statement and contract compliance reviews, vendor master file analysis and web-based audit management. 

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