RAC Program Paused by CMS
The Centers for Medicare & Medicaid Services (CMS) announced a pause in the Medicare Recovery Audit Contractor (RAC) Program until the procurement process is complete for the next round of contracts. Pursuant to the pause in the Program, the last day RACs were permitted to send postpayment Additional Documentation Requests (ADRs) was February 21, 2014. The last day Medicare Administrative Contractors (MACs) were permitted to send ADRs for the RAC Prepayment Review Demonstration was February 28, 2014. The last day RACs may send improper payment files to the MACs for adjustment is June 1, 2014.
CMS also announced several improvements to the RAC Program, including removing the restriction that providers must choose between initiating a discussion and an appeal, and delaying issuance of contingency fees to RACs until the second level of appeal is exhausted.
Updates to the RAC Program are available at:
A list of the improvements to be made to the RAC Program is available at:
“Recent Updates.” Feb. 18, 2014. Centers for Medicare & Medicaid Services. 20 Feb. 2014.
“RAC Program Improvements.” Jan. 2014. Centers for Medicare & Medicaid Services. 20 Feb. 2014. <http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/Downloads/RAC-Program-Improvements.pdf>.