Permanent Recovery Audit Contractors to be Announced in May

With the recovery audit contractor (RAC) demonstration program ending this past March, CMS expects to name the new, permanent RACs by May, announced Kimberly L. Brandt, CMS program integrity director, at the Health Care Compliance Association’s Compliance Institute held in New Orleans. With the recovery audit contractor (RAC) demonstration program ending this past March, CMS expects to name the new, permanent RACs by May, announced Kimberly L. Brandt, CMS program integrity director, at the Health Care Compliance Association’s Compliance Institute held in New Orleans.

The RACs will be tasked with:

• Detecting Medicare improper payments (including both underpay-ments and overpayments)
• Correcting Medicare improper payments (i.e., repay money to a provider who was underpaid or collect money from a provider who was overpaid)

The RACs will be required to use clinical staff, such as nurses, when conducting medical reviews. Each RAC will also have a Medical Director.

Once these new companies are announced to serve as the permanent RACs, CMS and the new RACs will conduct extensive provider outreach. CMS has said it will work with provider associations to help facilitate outreach.

To learn more about the RAC program, visit www.cms.hhs.gov/RAC.