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OIG Recommends CMS Prevent Improper Medicare Payments

The Office of the Inspector General (OIG) recommended that action be taken to ensure recovery audit contractors (RACs) identify and report improper payments and potential fraud to the Centers for Medicare & Medicaid Services (CMS). OIG released a report Sept. 4 that evaluated CMS’ oversight of RACs, who audit provider claims for the Medicare program. The report stated that in fiscal years 2010 and 2011, half of the claims RACs reviewed resulted in improper payments. While CMS took actions to correct this, the agency did not evaluate the effectiveness of those actions. As a result, OIG recommended four measures, including that CMS “take action, as appropriate, on vulnerabilities that are pending corrective action and evaluate the effectiveness of implemented corrective actions.” CMS concurred with most of the recommendations.

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