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Of the .33 billion that RACs collected in overpayments and underpayments in fiscal year 2013 through June 30, more than 0 million went to the auditors thanks to the contingency fees they charge, which range from 9.5 to 12 percent.Hospitals complain that the growing financial and administrative burdens from auditors seeking medical records to deny payments for services already delivered is causing them hardships and siphoning resources that should be devoted to patient care.The auditors are charged with recovering Medicare reimbursements improperly paid due to error. The four RACs, which were awarded contracts in different regions of the United States, collected million that first year, a figure that rose to 1 million in 2011 and has exceeded billion in each subsequent year.All that money didn't go back into federal coffers.But even hospitals that have successfully challenged the Recovery Audit Contractors program agree it is flawed, unfair and costly.In 2010, the Centers for Medicare & Medicaid Services expanded the Recovery Audit Program from the three states where it was piloted.They say RACs are slow to uncover underpayments to hospitals and too quick to find overpayments.

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The AHA's RACTrac survey also found that 40 percent of hospital claims denials are appealed and that hospitals prevail in those appeals 72 percent of the time.

D., system medical director for recovery audit and appeal services for the 15-hospital Ministry Health Care.



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