RAC program more accurate than lobbyists

Medicare’s much-criticized recovery audit program is far more accurate than hospital lobbyists say it is, though it’s far from perfect and detects too little fraud rather than too much, according to a new report from HHS’ Office of the Inspector General.

Of the 1.1 million cases in 2010 and 2011 in which a recovery auditor recommended denying Medicare payments, only 6% of those were ever appealed, according to figures drawn from Medicare’s database of recovery-audit claims. Healthcare providers won only 44% of those appeals, the OIG’s report said. Read more here.

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