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HMS, a wholly owned subsidiary of
HMS Holdings Corp. (NASDAQ:HMSY), announced today that it has achieved $3.1 million in Medicaid Recovery Audit Contractor (RAC) recoveries through collaboration with New York State’s Office of the Medicaid Inspector General (OMIG) and a corporate provider.
Using a process that compares commercial carrier paid claim data to Medicaid paid claim records, HMS identified a potential systemic
coordination of benefits issue with Medicaid billings within one of the provider’s facilities.
HMS then worked with the corporate provider to identify the affected claims at all of the provider’s stores. After engaging in a targeted self-review of their secondary and tertiary billings to Medicaid over the prior three years, the provider ultimately identified over 350,000 incorrectly billed prescriptions across the company’s 758 New York facilities.