WP13-KB (Medicare Recovery Audit Contractors)

Medicare Recovery Audit Contractors (RACs): What Providers Need to Know and How to PrepareR. Brent Rawlings, JD, MHA, FACHE804.775.1126 | rbrawlings@mcguirewoods.comOne James Center | 901 East Cary StreetRichmond, Virginia 23219-4030www.mcguirewoods.com©2007 American Health Lawyers Association, Washington, D.C. Original version of this article was published in the November 2007 issue (Volume 10, Issue 4) of The RAP Sheet. Reprinted with permission. Updated by author in December 2008.I. Introduction. On March 28, 2005, the Centers for Medicare and Medicaid Services (“CMS”) introduced a new demonstration project that would use Recovery Audit Contractors (“RACs”) to assist Medicare in identifying improper payments made to healthcare providers and suppliers not detected through existing program 1integrity efforts. The demonstration is now complete and proved to be successful in returning millions of dollars in overpayments to the Medicare Trust Fund. Convinced of the value of RACs to the Medicare Program, Congress passed into law Section 302 of the Tax Relief and Health Care Act of 2006, which mandates 2extension and expansion of RACs nationwide by no later than January 1, 2010. The demonstration project was conducted in three states - California, Florida, and New York. CMS’ current expansion strategy for the permanent recovery audit contractor program has RACs operating in twenty-three states by March 1, 2009 and the remaining twenty-seven states and ...