CMS Names First Audit Contractor for Home Health, DME in 2015

Just before the close of 2014, the Centers for Medicare & Medicaid Services (CMS) awarded its first national recovery audit contract for the new year to Connecticut-based firm Connolly, LLC—the first of five to be awarded.

The Region 5 contract awarded to the Connolly is national in scope and includes Medicare claims for Durable Medical Equipment (DME) as well as home health and hospice (DME/HH-H).

“This award marks the beginning of the new Recovery Audit contracts and is the start date of the implementation of many improvements to reduce provider burden and increase transparency in the program,” CMS said in a written statement. 

Headquartered in Wilton, Conn., Connolly LLC is a subsidiary of Connolly iHealth Technologies that currently provides similar payment integrity services to private healthcare insurers to help lower systemic costs and improve healthcare payment accuracy.

“This contract will benefit the entire Medicare program, including providers, who will know that they are being reimbursed accurately and consistently, Medicare beneficiaries who depend upon those services, as well as taxpayers who demand that the Trust Fund be protected,” said Connolly iHealth Technologies Vice President of Audit Operations Chad Janak in a written statement. 

The contract to Connolly is the product of previous determination from CMS that the federal agency would select recovery auditors to review Medicare claims within four geographic regions of the country, and a new fifth nationwide region focused on identifying overpayments and underpayments, specifically among DME, home health and hospice claims.

Having continuously served CMS as a Recovery Audit Contractor since the program’s inception in 2006, as mandated by the Tax Relief and Health Care Act, Connolly is the exclusive recovery audit prime contractor for Region C, which covers 17 states and territories in the southern portion of the U.S.

“We are pleased to be continuing our partnership with CMS and are honored to have been chosen as the first national contractor for DME/HH-H claims,” said Connolly President Steve Senneff.

Written by Jason Oliva

Jason Oliva

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