Health Plans    |    Blue Cross Blue Shield    |    Medicare    |    Medicaid    |    Pharma Manufacturers    |    Government    |    CMS RAC Program

CMS Recovery Audit Program

Healthcare costs are rising steadily, putting stress on our economy and our families. With as many as 12%* of all insurance payments made in error, Connolly’s work to identify errors and address their root cause can help improve healthcare and make it more affordable for all of us.

The Recovery Audit program is a cost containment effort aimed at reducing improper payments within Medicare programs as well as identifying process improvements to reduce or eliminate future improper payments. Connolly was the prime contractor for NY State in the Medicare RA demonstration project and was subsequently awarded the contract to provide Medicare recovery audit services for CMS as mandated by the Tax Relief and Health Care Act of 2006. Connolly is the exclusive RA prime contractor for region C, the largest region, covering 35% of all claim volume from 17 states and territories in the southern portion of the US. To date, the program has resulted in the correction of more than $8 billion in erroneous payments.


*In its FY 2014 Agency Financial Report, The Department of Health and Human Services reported an overall fee-for-service error rate of 12.7 percent, representing $46.3 billion in improper payments


For additional information about the program, please see the following links:

RA Program Overview

CMS RA Program FAQs

CMS RA Program Myths

Council for Medicare Integrity

CMS Manuals

Medicare Coverage Database


For information about the availability of auxiliary aids and services, please visit:


 Navigation Links


 Important Links


 RAC Provider Resources


 FAQs - PIP Adjustments

Click here to view Frequently Asked Questions regarding "RA Adjustments for Periodic Interim Payment Providers (PIP)"