BALTIMORE — The four recently named recovery audit contractors poised to begin provider education this month were told last week to halt all work pending a review of protests filed by two companies that failed to win RAC contracts, CMS said.
The new RACS, which were tabbed in October to ferret out Medicare overpayments and underpayments, were scheduled to introduce the program via what CMS called "town hall-type meetings" this month, but protests to the Government Accountability Office by Viant and PRG-Schultz, which lost out in the contracting process, derailed those plans. The GAO has 100 days to review the complaints and issue a decision.
CMS said, however, it will hold a previously announced Special Open Door Forum on the RACs this Wednesday.
"CMS staff will continue informing the provider community," said Connie Leonard, director of the division of recovery audit operations for CMS. According to a notice from the agency, the purpose of the forum is "to introduce providers to the new contractors and provide more information about the RAC program."
The RAC program was mandated by the Tax Relief and Health Care Act of 2006 as a way for CMS to identify Medicare overpayments and underpayments for both Part A and Part B (which includes home medical equipment providers). In a three-year demonstration project involving six states—California, Florida, New York, Massachusetts, South Carolina and Arizona—more than $900 million in overpayments was collected and $38 million found in underpayments, according to CMS. (See CMS Rolls Out Host of New Anti-Fraud Measures, HomeCare Monday, Oct. 13.)
Those results propelled CMS to implement plans for permanent RACs. After calling for bids, CMS in October awarded four contracts—mirroring the DME MAC jurisdictions—and charged the contract winners with establishing the program of post-payment reviews, which will eventually roll out to all 50 states by 2010. The companies awarded the contracts included:
- Region A: Diversified Collection Services of Livermore, Calif., initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and New York
- Region B: CGI Technologies and Solutions of Fairfax, Va., initially working in Michigan, Indiana and Minnesota
- Region C: Connolly Consulting Assoc. of Wilton, Conn., initially working in South Carolina, Florida, Colorado and New Mexico
- Region D: HealthDataInsights of Las Vegas, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona
Leonard said CMS did not know when the RACS would be able to begin their outreach education.
"CMS will not be able to answer those questions until after the GAO makes a determination concerning the protests," she said.
To access Wednesday's CMS Open Door conference, which is scheduled from 2 to 3:30 p.m. EST, call 800/837-1935 and reference conference ID 60227754.
For more information visit the RAC program.