According to the report, recovery auditors corrected more than $2.57 billion in improper payments for FY 2014 – representing 5% of the $46 billion in wasted taxpayer dollars the program lost in a comparable period to fraud, waste and abuse.

Kristin Walter

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Just like the IRS you can’t prevent gaming the system if the system is flawed.  Paying for outcomes not income would go a long ways in eliminating Government interpretations that use ex post facto rules for enforcement penalties related to input not output.  Until the payment system matches the results not the diagnosis or encounter or script we have no way of managing our resources.  If bundling and population health is to work payment must be on episode results not diagnostic gaming and waste.  the Federal Government’s (RAC) recovery audit is like transparency it is reactionary to whatever fraud and abuse exists and at best a part of the flawed reimbursement systems dictated by CMS for Medicare and Medicaid now being embraced by ACO networks.