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Medicare Fee for Service Recovery Audit Program

Mission - The Medicare Fee for Service (FFS) Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments in all 50 states.

Background - The Medicare FFS Recovery Audit Program began as a demonstration required in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The demonstration was conducted from March 2005 to March 2008 in six states to determine if Recovery Auditors could effectively be used to identify improper payments for claims paid under Medicare Part A and B. This demonstration allowed for additional review of Medicare claims for payment by utilizing Recovery Auditors on a contingency fee basis to identify and investigate claims with calculated risk. The demonstration established Recovery Auditors as a successful tool in the identification and prevention of improper Medicare payments. Section 1893(h) of the Social Security Act authorized the Recovery Audit Program expansion nationwide by January 2010. 

The RAC in each region is as follows:

Region A:  Performant Recovery 

Region B:  CGI Federal, Inc. 

Region C:  Cotiviti Healthcare 

Region D:  HealthDataInsights, Inc.

All correspondence, web sites and call centers will be in the name of the RACs above. Click the link below to obtain contact information for each RAC.

Do you have questions or comments about the Recovery Audit Program? Please e-mail us at: Please Do Not send Personal Health Information to this e-mail address.