Connolly snags contract for DME-specific RAC

Tuesday, January 6, 2015

WASHINGTON – CMS has awarded a national contract to identify overpayments specifically for DME, home health and hospice to Connolly, the agency announced Dec. 30.

CMS announced its plans to create a fifth recovery audit contractor (RAC) back in 2013.

Wilton, Conn.-based Connolly is already the RAC for Jurisdiction C, the largest of the four jurisdictions.

Along with the RAC, CMS will implement a number of improvements to its audit program, including requiring the RACs to wait 30 days before sending claims to the MACs for adjustment, keeping the RACs from collecting contingency fees until the second level of appeals is exhausted and putting in place a provider relations coordinator.

The four existing RACs will continue to identify overpayments in Jurisdictions A, B, C and D, but they will focus on hospitals and other healthcare providers.