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This document includes links to CMS details regarding the RAC Program. Recovery Audit Program Home Page Medicare FFS RAC contact info (12.6.16) [PDF, 223KB] Medicare FFS RAC Map – November 2016 [PDF, 244KB] Nov. 30, 2016 RAC SOW Regions 1-4 [PDF, 517KB] Nov. 30, 2016 RAC SOW Region 5 [PDF, 1MB] Medicare Learning Network Provider […]
From the HHS News Release: A greatly expanded website to give small business owners an unprecedented detailed review of their health insurance plan choices was announced today by the U.S. Department of Health and Human Services. Just in time for 2012, this powerful new tool allows small business owners to compare the benefits […]
From the HHS Fact Sheet: In 2010, the President announced three goals for cutting improper payments by 2012: reducing overall payment errors by $50 billion, cutting the Original Medicare error rate in half, and recovering $2 billion in improper payments to recipients of federal dollars. As a part of the Centers for Medicare & […]
From the HHS Fact Sheet: The Rebilling demonstration will allow CMS to compensate providers for providing needed care to Medicare patients. At the same time, it continues to encourage providers to deliver services to patients in the most appropriate care setting. It will also effectively lower the improper payment rate, as payments that would […]
From the HHS Fact Sheet: Today, Recovery Auditors work on a contingency basis to identify improper payments after the claims have been paid – the traditional “pay and chase” method of recovering improper payments. The most effective way to limit the amount of taxpayer dollars lost to this type of improper payment is […]
2011 Original Medicare Improper Payment Error Rate The 2011 Original Medicare FFS program improper payment rate was 8.6 percent. While CMS continued to review claims according to a significantly revised and improved methodology as implemented in 2009 in consultation with the Health and Human Services Office of Inspector General (OIG), the methodology was further refined […]
2011 Medicare Advantage (Part C) Improper Payment Error Rate For FY 2011, CMS is reporting a Part C composite improper payment rate estimate of 11 percent, based on CY 2009 payments. This represents a three percentage point reduction from the FY 2010 Part C composite improper payment rate of 14.1 percent. This improvement can be […]
2011 Medicare Part D Improper Payment Error Rate For fiscal year (FY) 2011 reporting, HHS will report its baseline composite Part D improper payment error rate estimate of 3.2 percent. This rate is reported in the HHS FY 2011 Agency Financial Report (AFR), and is based on Calendar Year (CY) 2009 final Part D payments. […]
2011 Medicaid Improper Payment Error Rate The 2011 Medicaid improper payment error rate is 8.1 percent. This represents a drop in the improper payment rate from 2010 (9.4 percent).[1] CMS measures Medicaid improper payments through the Payment Error Rate Measurement (PERM) program and produces state and national-level error rates for each program. The error rates […]
