E.1 Proposed Contingency Fee.xlsx

This document contains a solicitation for Recovery Audit Contractor (RAC) services for Region 2. The solicitation seeks proposals for reviewing Medicare Fee-for-Service claims submitted to and paid by A/B Medicare Administrative Contractors in Region 2, excluding Durable Medical Equipment, Prosthetics, Orthotics, and Supply claims and Home Health/Hospice claims. The selected contractor will review claims through appropriate methods including automated review, complex review, review of CMS referrals, and use of extrapolation. The contractor will work with CMS and MACs to adjust claims, recoup overpayments, pay underpayments, support the appeals process, and update the RAC Data Warehouse with monthly reporting. Proposers are asked to specify a single contingency fee percentage to be applied to recoveries and repayments across four categories of improper payment identification. The solicitation is issued by the Department of Health and Human Services Centers for Medicare and Medicaid Services as solicitation number 75FCMC21R0018.