CMS Releases First Medicare RAC Appeals Update

Posted on: July 31st, 2012 by hmshealthcare

CMS data shows that providers won appeal decisions for more than 43% of the Medicare Recovery Audit Contractor (RAC) claims that they appealed in FY2011, which represents almost $38M.

Of the 900K claims that RACs determined were overpayments, 56K were appealed by providers. Decisions were made in favor of the provider in nearly 25K of those claims.

A closer look at the numbers reveals that providers won the most money back when they appealed complex reviews.

The full report, which includes a breakdown by claim type, can be read here.

 

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