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CMS Corrects Improper Payment Figures, Statistics

James Carroll, for HealthLeaders Media, June 19, 2012

In the last month, the Centers for Medicare & Medicaid Services posted two separate sets of data that provide nationwide statistics on its Recovery Auditor program. The first update contains improper payment figures and top Recovery Auditor issues per region. In the second update, CMS provides appeals statistics for fiscal year 2011.

Improper payment figures and top issues
Recovery Auditor activity saw a huge spike in the latest quarter, as statistics for overpayments and underpayments both saw significant increases. For the time period January 2012 through March 2012, CMS identified $588.4 million in overpayments and $61.5 million in underpayments for a total of $649.9 million in corrections. These numbers are up from $397.8 million and $24.9 million from last quarter, respectively. They have climbed considerably since the start of the permanent program.

In total, CMS has identified $1.86 billion in overpayments and $245.2 million in underpayments for a sum of $2.1 billion in total corrections since the beginning of the Recovery Auditor program.

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