- The Centers for Medicare and Medicaid Services in December announced that it has extended its contracts with the four private companies that manage the organization's recovery audit program. The four companies are CGI Federal, Connolly, HealthDataInsights and Performant Recovery.
- The contracts were originally slated to end in February of last year, but were extended to December 31.
- Under the new extension, the companies will be responsible for identifying and ameliorating improper Medicare payments until December 31, 2015; They will also remain under contract until April 30, 2017 for administrative purposes.
The Medicare Recovery Audit Contractor (RAC) program recouped almost $4 billion in improper payments in fiscal year 2013. The majority—$3.65 billion—were overpayments, with 94% of that figure resulting from inpatient hospital claims. Many were from short-stay inpatient hospital admissions determined after the fact to be medically unnecessary.
The program has met with mixed results. While some groups, like the American Coalition for Healthcare Claims Integrity, touted the October report revealing those figures as a sign of the importance of the program, at least one provider group attorney criticized the program for using "fuzzy math."