CMS announces new Medicare RAC contracts

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CMS awards new Medicare RAC contracts – November 1, 2016, AHA News Now

The Centers for Medicare & Medicaid Services today named its new Medicare Recovery Audit Contractors. Three contractors will perform post-payment review of Part A and B Medicare fee-for-service claims for all provider types other than home health/hospice and Durable Medical Equipment, Prosthetics, Orthotics and Supplies: Performant Recovery Inc. in Region 1, Cotivit LLC in Regions 2 and 3, and HMS Federal Solutions in Region 4. In addition, Performant Recovery will perform post-payment review of home Health/Hospice and DMEPOS claims nationally. CMS last year announced improvements to the RAC program, some of which could not be implemented until the new contracts were awarded. CMS said the awards continue the implementation of many program enhancements designed to reduce provider burden, enhance program oversight and increase transparency….

G2X TAKE: CMS announced the award mid-day yesterday for three new Medicare Recovery Audit Contractors to support 5 regions. Now comes the waiting game as these firms brace for possible protests.

The winners were listed as Performant Recovery, Inc for Regions 5 and 1; Cotiviti, LLC for Region 2 and 3; and HMS Federal Solutions for Region 4. Solicitation Details and awards can be found here.

This is the second big win of the year for HMS Federal at CMS, as they were one of 7 awardees for the $2.5B Unified Program Integrity Contract (UPIC) IDIQ early this year. We should note that HMS Federal recently posted a job opening for an executive to support growth for this 2300+ person Healthcare solutions firm - details here. 

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