New Recovery Auditor Contracts Announced

CMS has awarded five new contracts for the next round of the Recovery Audit Program, the agency announced October 31. The contracts were awarded to:

• Region 1: Performant Recovery, Inc.
• Region 2: Cotiviti, LLC
• Region 3: Cotiviti, LLC
• Region 4: HMS Federal Solutions
• Region 5: Performant Recovery, Inc.

The base period for contracts is 12 months from the date the contract is awarded.

Recovery Auditors (RA) in Regions 1 through 4 will conduct postpayment reviews of Medicare Part A and B claims, while Region 5 RAs will review home health/hospice and durable medical equipment, prosthetic, orthotics, and supplies nationally.

The program has been a burden to providers since it was launched nationally in 2010, according to the American Hospital Association, and created a backlog of appeals at the Administrative Law Judge level. But RAs have been a boon to CMS, recouping more than $9 billion dollars in overpayments since 2010.