Home Health & Hospice Week

Little secret: The RACs flagged $1 billion in improper payments -- and only 2 cases of fraud. If you're wondering how often a Recovery Audit Contractor's review of overpayments turns into a federal fraud investigation, a recent report from a federal watchdog agency says "not often enough." Step up the fraud hunting, the HHS Office of Inspector General urges the Centers for Medicare & Medicaid Services in the report. The OIG examined how often the RACs selected to participate in the demonstration project referred potential fraud cases to CMS. During the period between March 2005 and March 2008, participating RACs identified $1.03 billion in improper Medicare payments -- 85 percent of which came from inpatient hospital facilities. However, during the same time period, all the RACs together referred only two cases for CMS to investigate for fraud. And, there must have been some kind of communication break, because CMS reports getting no [...]