Oct

02

APPEALS UPDATE: CMS publishes new numbers on RAC demonstration project

By The RAC Report

The percentage of successful provider appeals on RAC overpayments increased from 4.6% to 6.8% as reported in a CMS update to its RAC demonstration project evaluation.

The update, released last week, reports appeals numbers through June 30, 2008. The original demonstration project report had numbers only through March 27, 2008.

Of the number of claims with overpayment determinations (525,133), providers have won 35,819. CMS says there are 1,607 appeals pending at the ALJ level (worth $12.0 million), the third level of appeals. CMS says it is not able to determine the number of appeals pending at the first level.

The percentage of overpayment rulings appealed also climbed – from 14% to 19.6%. CMS promised to update numbers throughout the fall.

For the complete updated report, click here.