HMS Holdings Corp. (NASDAQ: HMSY)—a leading provider of cost-containment services for Medicare, Medicaid, and other healthcare payers—today announced that its wholly owned subsidiary HealthDataInsights, Inc. ( HDI), a Medicare Recovery Audit Contractor (RAC), reached the milestone of $1 billion in corrections for overpayments and underpayments since the inception of the national program in 2009.
The size of HDI’s territory also highlights the effectiveness of its work in program integrity. The company is the Medicare RAC for region D—which includes only 17 states and three territories—and HDI has generated 36% of all corrections to date.
The $1 billion mark in corrections reaffirms the outperformance of HDI’s purpose-built technology, first seen during the three-year pilot program. Since then, the company has continued to refine its system to locate ongoing cost-saving opportunities for the Centers for Medicare and Medicaid Services (CMS).
“CMS’s Comprehensive Error Rate Testing Report, released in November 2012, reported the improper payment rate was 8.6%, representing $28.8 billion in improper payments,” said Andrea Benko, president of HDI. “We’re proud to recover a fraction of those dollars so Medicare can do more for those who need help most.”About HMS Holdings Corp. HMS Holdings Corp., through such business units as HMS and HDI, provides coordination of benefits and program integrity services for payers. These units serve health and human services programs in more than 40 states; commercial programs, including commercial plans, employers, and over 135 Medicaid managed care plans; the Centers for Medicare and Medicaid Services (CMS); and Veterans Administration facilities. As a result of these services, clients recovered more than $2.5 billion and saved nearly $7 billion through the prevention of erroneous payments in 2011.
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