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Coming to a Theater Near You: Recovery Audit Contract Initiative

Coming to a Theater Near You: Recovery Audit Contract Initiative


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This article describes the expansion of a Medicare demonstration project called the Recovery Audit Contractor Initiative. The goal of this initiative is to identify overpayments by Medicare intermediaries and payors, and return the money to the Medicare program. The initial demonstration project, in Florida, California, and New York, recovered significant monies for Medicare. Medicare hires private contractors that select claims to review based on data analysis. The contractors are paid on a percentage-of-collections basis. Congress has mandated that the program be expanded to all states by 2010.