Recovery Audit Contractors are charged with supporting Medicaid program integrity.
RACs work with state agencies to determine if Medicaid claims were paid appropriately and to correct those that were not.
CMS’ final rule on Medicaid RACs was issued on September 14th, 2011
The Affordable Care Act (ACA) requires Medicaid agencies to contract with Recovery Audit Contractors (RACs) to identify and recover overpayments and to identify underpayments. States must also develop processes for entities to appeal RAC determinations, and coordinate RAC efforts with other Federal and state law enforcement agencies.
Most states have begun to develop comprehensive Medicaid RAC solutions to meet ACA requirements. Stay up to date on Medicaid RAC activity by state with this interactive map.
CMS released its final rule on the Medicaid RAC program on September 14th, 2011.
See HMS’ blog post, “Ten Things Stakeholders Should Know about CMS’ Final Rules on Medicaid RACs.”