The RACs will be tasked with:
- Detecting Medicare improper payments (including both underpayments 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, click here.
