OIG Recommends More CMS Attention to Recovery Audit Contractor Program

September 13, 2013 | Aging Services Risk, Quality, & Safety Guidance

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​The Centers for Medicare and Medicaid Services’ (CMS) oversight of its recovery audit contractors (RACs) and measures to address improper payment vulnerabilities identified by RACs are insufficient, says a report from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). The RAC program went into effect in late 2009 to assist the agency in identifying improper payments made by the Medicare program and in recouping those payments. RACs receive a percentage of any payments recovered or returned to providers. In its report, OIG found that even though the RAC audits helped CMS identify 46 vulnerabilities that resulted in improper payments in fiscal years 2010 and 2011, the agency had only put measures in place to address 28 of the vulnerabilities.

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