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7/19/2010
Recovery Audit Contractors Evaluation: Providers Win 64.4% of Cases

Recovery Audit Contractors Evaluation: Providers Win 64.4% of Cases
CMS recently issued a national evaluation of appeals that took place during its three-year Medicare Recovery Audit Contractor demonstration project. The breakdown of appealed claims shows that providers won 64.4% of the time during the three-year period. Providers appealed 76,000 claims and received favorable decisions on 49,000. The new health care reform law requires every state to contract with an RAC to pursue Medicaid
recoveries.