HEALTH

Evaluation of Medicare recovery audit contractor demonstration project
Centers for Medicare and Medicaid Services

On behalf of the Centers for Medicare & Medicaid Services (CMS), Econometrica is evaluating the three-year Medicare Recovery Audit Contractor (RAC) demonstration authorized by the Medicare Prescription Drug and Modernization Act of 2003. That Act required the Secretary of Health and Human Services to conduct a demonstration project for the Medicare population to investigate the use of recovery audit contractors (RACs) under the Medicare Integrity Program in identifying underpayments and overpayments, and in recouping overpayments under the Medicare program for services in which payment is made under part A or B of title XVIII of the Social Security Act. Econometrica’s work under this task order contract includes the following five major tasks:

• Evaluate the demonstration utilizing cost accounting, cost-benefit analyses, and other techniques designated by CMS as deemed appropriate for a thorough evaluation

• Design, develop, and field provider surveys to gauge provider communications with the RACs.

•Conduct site visits to examine best practices and the operations of RACs and other Medicare-affiliated contractors.

• Provide assistance to CMS in drafting reports to Congress that include information on the impact of the demonstration on savings to the Medicare program and recommendations on the cost-effectiveness of extending or expanding the demonstration.

• Provide recommendations to CMS on all aspects of the evaluation, including best practices and recommendations for a roll-out across other states.
Review and dissemination of research on achieving drug-free workplaces