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Article: RAC reviews: are you ready? CMS is ready to expand its recovery audit contractor (RAC) program across all states.
- Article from:
- Revenue Cycle Strategist
- Article date:
- July 1, 2008
- Author:
CopyrightCOPYRIGHT 2008 Healthcare Financial Management Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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The RAC demonstration program recovered $247.4 million in FY07 from just three states: New York, Florida, and California. Nearly $440 million has been collected since 2005 when the program was initiated. Created under the Medicare Modernization Act of 20o3, the RAC demonstration program was developed to identify Medicare overpayments and underpayments and to recoup Medicare overpayments, with the RACs being paid a percentage of the findings.
There are two types of RACs: Claim RACs and Medicare Secondary Payer (MSP) RACs. The RACs can perform reviews in two ways: They can use proprietary software programs to identify potential payment errors (automated reviews), ...