CMS releases several RAC updates in October

CMS made several announcements in October related to the development its permanent Recovery Audit Contractor (RAC) program.

On Oct. 9, CMS announced that it has hired Provider Resources, Inc., Erie, Pa., to work as the RAC Validation Contractor, which provides additional oversight to ensure that RACs are making accurate claim determinations in the permanent program. The Validation Contractor works with CMS and RACs to approve new issues that the RACs want to pursue for improper payments. In addition, the Validation Contractor performs accuracy reviews on a sample of randomly selected claims where the RACs have already collected overpayments.

On Oct. 10, CMS published an award notice announcing the contingency fees that will be paid to the RACs for each region. The contingency fees vary for each region, since the fees were established during separate contract negotiations. The contingency fees are:

• 12.45 percent for Region A, managed by Diversified Collection Services, Inc.
• 12.5 percent for Region B, managed by CGI Technologies and Solutions, Inc.
• 9 percent for Region C, managed by Connolly Consulting Associates, Inc.
• 9.49 percent for Region D, managed by HealthDataInsights, Inc.

In related news, CMS announced in Transmittal 142 [LINK TO http://www.cms.hhs.gov/transmittals/downloads/R142FM.pdf ] that effective Oct. 22, the agency has changed the interest rate for overpayments and underpayments to 11.375 percent.