Providers appealed more improper payment decisions made by its Recovery Audit Contractors than CMS first reported, the agency said last week. Of the more than 525,000 overpayment determinations made by the RACs between 2005 and 2008, providers appealed more than 118,000, or 22.5 percent.
Of the decisions that were appealed, CMS said, 34 percent were overturned in providers' favor. In its initial report in July, the agency said providers had appealed only 14 percent of the determinations.
In the three-year RAC demonstration, which involved six states, as of March the audits had identified more than $1 billion in improper payments, including $38 million in underpayments to providers. Those results propelled CMS to name permanent RACs, with plans to roll out the post-payment reviews to all 50 states.
For more on the RAC program, see CMS Launches Anti-Fraud Demo; Industry Asks, What Took You So Long?, HomeCare Monday, Nov. 17, 2008.
