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Medicare Recovery Audit Contractor (RAC) ProgramThe Medicare Recovery Audit Contractor (RAC) program is authorized by Congress to identify improper Medicare payments – both overpayments and underpayments. RACs are paid on a contingency fee basis, receiving a percentage of the improper payments they identify and collect. Following a three-year demonstration project, the law requires the Centers for Medicare & Medicaid Services (CMS) to expand the program nationwide by 2010. The national expansion of the RACs is being introduced by region, with Iowa slated sometime after August 2009.
HealthDataInsights, Inc. (HDI) has been named the RAC contractor for RAC region D, which includes Iowa. RACs must conduct outreach efforts in each state and cannot begin any audit work in a particular state until the outreach has been completed. Iowa is scheduled for outreach on August 25.
Program materials and registration forms will be available soon.
Join the Iowa RAC coordinators' list serve. The list serve is an opportunity to share RAC questions, answers and ideas. Click here to subscribe. If you have already to subscribed, click here to send an e-mail to the group.
Below are links to informational Web sites:
HealthDataInsights RAC Web Site
American Hospital Association RAC Web Site
Below are documents that will help you to understand the current status of the RAC program and to prepare for the RAC reviews.
The American Hospital Association (AHA) is providing to all hospitals, free of charge, a claim-level tracking tool, the RACTrac. This tool will help hospitals to monitor the status of claims in order to present appeal rights on every claims that is identified as an overpayment. To learn more about this tool, click here.
RAC: The New York State Experience (PowerPoint Presentation)
August 25 Iowa Outreach Session Handouts: HDI CMS
AHA Advisory/Bulletin - RAC Permanent Program Basics
AHA Advisory/Bulletin - Coding and Documentation
AHA Advisory/Bulletin - New RAC
CMS Update - Evaluation of Demonstration
Appeals - AHA Regulatory Advisory - March 2009
Office of the Inspector General (U.S. Department of the Health and Human Services)
Comprehensive Error Rate Testing Contractor
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