RACs recover a whopping $162 million in overpayments in Q1 2011

Recently, CMS released new data on the amount of overpayments and underpayments collected by RACs in the first quarter of 2011. As per the report, the total overpayments collected during this period totaled $162 million while underpayments totaled $22.6 million.

According to the report, RACs identified $365.8 million in overpayments made to Medicare providers from October 2009 through March 2011. During the fiscal year 2010 (Oct. 2009 through Sept. 2010), RACs collected $75.4 million from practices that were overpaid by their Medicare contractors – however that number is nothing in comparison to the amount the RACs collected in just the first three months of this year.

Good tidings: Despite their reputation as ‘bounty hunters’, the RACs do appear to be returning money to practices that were underpaid. During the first quarter of this year, the RACs returned $22.6 million to practices. All said, they found $184.6 million in incorrect Medicare payments during the first three months of this year.

The CMS report reveals several of the overpayment errors that the RACs discovered. For example, Region A RAC (Diversified Collection Services) found that practices were wrongly adding the number of ventilation hours that practitioners billed, ending in higher reimbursement. The RAC reminds practices that “ventilation hours begin with the intubation of the patient and continue until theendotracheal tube is removed, the patient is discharged/ transferred, or the ventilation is discontinued after a weaning period.