Medicare RAC Recovery Efforts Summarized in Quarterly Newsletter

On May 18, 2012, Medicare released their 2nd Quarter Newsletter regarding the recovery efforts of each of the region’s Recovery Audit Contractors: DCS, CGI, Connolly, and HDI.

CGI Federal has the lowest level of overpayment recoupments and underpayment identification. Connolly and HDI/HMS are identifying and correcting exceedingly more improper payments compared to CGI and DCS.

Total improper payments (over and under) increased over 50% between the 1st and 2nd quarters of FY 2012. Total improper payments have already exceeded $1 billion and we are only half way through the year. In 3 out of the 4 regions; the #1 recoupment issue is identified as cardiovascular procedures. Region D reports same day or minor procedures as its #1 issue.

Of all of the areas where hospitals experienced success in the appeal process, sort stay inpatient surgeries were the area where they had the most success.

For more information regarding this issue, please contact Abby Pendleton, Esq. or Jessica Gustafson, Esq. at 248-996-8510 or visit The HLP website.