Cotiviti GOV Services Awarded Contracts for CMS Recovery Audit Contractor (RAC) Region 3, Region 4, and Region 5

Contract will support CMS in safeguarding payment integrity for Medicare fee-for-service beneficiaries

Cotiviti GOV Services, LLC, a long-standing partner of Federal Government healthcare agencies and programs for more than 20 years, has been named by the Centers for Medicare & Medicaid Services (CMS) as the designated Recovery Audit Contractor (RAC) for Region 3, Region 4, and Region 5. These three contracts, awarded through a competitive procurement process, will support postpay review of Medicare claims in these regions to efficiently identify and correct overpayments and underpayments made to healthcare providers with a focus on the quality, accuracy, and transparency of reviews; recovery of improper payments; and minimizing provider burden.

“We are honored to continue our long-standing partnership with CMS by delivering our advanced technology, data analytics, and specialized expertise to support the RAC Program, as well as continue to identify other opportunities to invest in our solutions and partnerships in the government market,” said Chris Coloian, executive vice president of Cotiviti, Inc. and general manager of Cotiviti GOV Services, LLC.

CMS RAC Region 3 comprises eight states in the Southeast and two territories, while Region 4 comprises 17 states in the West and Mid-Atlantic, Washington, D.C., and three territories. As the incumbent for these regions, Cotiviti will continue to conduct postpay review of Medicare fee-for-service claims. RAC Region 5, which will transition from the previous contractor to Cotiviti GOV Services, comprises all fee-for-service claims nationwide for durable medical equipment and prosthetic, orthotics, and supplies (DMEPOS) as well as home health and hospice (HH&H).

About Cotiviti

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.

About Cotiviti GOV Services

Cotiviti GOV Services’ payment integrity solutions empower government agencies in the prevention and pursuit of errors, fraud, waste, and abuse, spanning the entire claim payment spectrum. These solutions enable both public and private payers in the continuing shift from postpay recovery of improper payments to automated prepay identification and prevention of improper payments for inappropriately coded claims to increase efficiency and protect beneficiaries. Cotiviti GOV Services delivers multiplatform payment integrity and quality improvement solutions that drive effective and efficient management and stewardship of mission-critical programs, supporting agencies such as the Centers for Medicare & Medicaid Services (CMS), Veterans Health Administration (VHA), Centers for Disease Control and Prevention (CDC), and the Defense Health Agency (DHA).

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