CMS Proposes Standards for Medicaid Recovery Audit Contractors (RACs)
On November 10, 2010, CMS published a proposed rule that would provide guidance to states on funding and operation for the Medicaid RAC program. By way of background, the ACA requires all states to contract with RACs to audit Medicaid claims, identify underpayments and overpayments, and recover overpayments or correct underpayments (similar to the Medicare RAC program). The proposed rule would address federal/state funding of Medicaid RAC costs, state payments to RACs, provider appeal provisions, and requirements to coordinate with other program integrity efforts. Comments on the proposal will be accepted until January 10, 2011.
