CMS Releases Report on Recovery Audit Statistics

December 11, 2012

CMS has posted on its website the latest RAC statistics. The statistics for the 4th quarter of FY 2012 show CMS collected $648 million in alleged overpayments and returned $46.5 million in underpayments. CMS' report on the total amounts collected and returned from October 1, 2009 through September 30, 2012, indicates that $3.16 billion in overpayments were collected and $268.2 million in underpayments were returned. The top issue for each of the four RAC regions remains whether inpatient hospitalizations (rather than outpatient stays) were medically necessary.

For FY 2012, CMS collected $397.7 million in the 1st quarter, 588.4 million in the 2nd quarter, 657.2 million in the 3rd quarter and $648 million in the 4th quarter for a total of $2,291.3 billion in FY 2012.

For more information on this issue, please contact Abby Pendleton, Esq. or Jessica Gustafson, Esq. at (248) 996-8510 or visit the HLP website.