February 9, 2009

THE RACE IS ON, THE RACs RETURN

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The Capital Building in Washington, DCAs reported first by RACMonitor last Friday (Feb. 6, 2009), the resolution of the dispute by the Government Accountability Office (GAO) between The Centers for Medicare & Medicaid Services and two unsuccessful bidders for the Recovery Audit Contractor program means that the RAC program is back on track.

 

On Nov. 4, 2008, CMS announced it had been required under the Competition in Contracting Act to place an automatic stay on the contract work of the RAC program as a result of two protests filed with the GAO by Viant Payment, Inc. and PRG-Schultz USA, Inc., two companies challenging the awarding of contracts under the RAC program.

 

Both Viant and PRG withdrew their protests last week, and the GAO closed the files for each without further action, according to a written statement submitted by the GAO to RACMonitor.com.

 

According to CMS, the four RACs will contract with subcontractors to supplement their efforts. PRG-Schultz, Inc. will serve as a subcontractor to HDI, DCS and CGI in regions A, B and D, while Viant, will serve as a subcontractor to Connolly Consulting in region C. Each subcontractor has negotiated different responsibilities in each region, including some claim review.

 

The RAC in each jurisdiction is as follows:

 

Region A: Diversified Collection Services (DCS)
Region B: CGI
Region C: Connolly Consulting, Inc.
Region D: HealthDataInsights, Inc.

 

In the three-year demonstration, RACs corrected more than $1.03 billion of improper Medicare payment. Of that amount, CMS says approximately 96 percent was overpayments collected from providers and a scant 4 percent was underpayments repaid to providers.

 

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Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the executive producer and program host of Monitor Mondays.

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