Who contracts with CMS to identify improper Medicare FFS payments?

Recovery Audit Contractors (RACs) are the entities that contract with the Centers for Medicare & Medicaid Services (CMS) specifically to identify improper payments made in the Medicare Fee-for-Service (FFS) program. Their primary role involves reviewing claims and payment patterns to detect any overpayments or underpayments.

RACs utilize a range of methods such as automated reviews, medical record requests, and complex reviews to determine whether the Medicare payments were appropriate according to regulations. By focusing on identifying these discrepancies, they help ensure that the Medicare program remains financially stable and that resources are appropriately allocated. This is crucial in maintaining the integrity of the Medicare system.

In contrast, healthcare providers, while they are impacted by the findings of RACs, do not have the responsibility nor the authority to conduct audits on Medicare payments. Insurance companies generally deal with different aspects of healthcare financing rather than the specific task of auditing Medicare payments. Quality assurance teams may conduct reviews within a healthcare organization but do not operate under a contract specifically with CMS for the purpose of identifying improper Medicare FFS payments. Thus, Recovery Audit Contractors stand out as the correct answer due to their designated role and contractual relationship with CMS.