CMS Reports $162 Million In Medicare Overpayments in First Three Months of 2011

Based on a recent report released by CMS, its Medicare Fee-for-Service Recovery Audit Program recovered $162 million in Medicare overpayments during the period of January through March 2011. This is a substantial increase in the amount of money recovered by the Recovery Audit Program (RAP) in that $162 million is more than double the amount that it recovered during the prior three-month time period. In fact, recoveries during the past three months are more than twice the amount the RAP program recovered from October 2009 through September 2010.

The report identifies the most common overpayment issue for each of the Recovery Auditors in the program, which include incorrect coding and separately billing for bundled services. This report also shows that $22.6 million in underpayments were returned to providers under the RAP program this year alone.

This post was contributed by Kurt E. Bratten.


Kurt Bratten

About Kurt Bratten

Kurt Bratten is Partner in our Health Law Department. His practice includes a wide range of civil litigation, transactional work and compliance and other advisory services. Kurt’s primary focus is counseling health care providers regarding compliance and transactional matters including managed care contracting, HIPAA and other confidentiality rules, anti-kickback and self-referral requirements, and other provider group-specific state and federal regulations.