CMS Announces RACs

The Centers for Medicare & Medicaid Services (CMS) awarded contracts to four permanent Recovery Audit Contractors (RACs) as announced in an Oct. 6 Fact Sheet. They are:

  • Diversified Collection Services, Inc. of Livermore, Calif.: Region A, initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and New York.
  • CGI Technologies and Solutions, Inc. of Fairfax, Va.: Region B, initially working in Michigan, Indiana, and Minnesota.
  • Connolly Consulting Associates, Inc. of Wilton, Conn.: Region C, initially working in South Carolina, Florida, Colorado, and New Mexico.
  • HealthDataInsights (HDI), Inc. of Las Vegas, Nev.: Region D, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah, and Arizona.

CMS says more states to come in 2009.

According to CMS, you can expect these RACs to:

  • Conduct more stringent reviews of new durable medical equipment, prosthetics and orthotics supplier (DMEPOS) applications;
  • Make unannounced visits on suppliers and home health agencies (HHAs);
  • Implement pre- and post-payment reviews of claims submitted by suppliers, HHAs and ordering or referring physicians;
  • Validate claims submitted by physicians who order a high number of certain items or services; and
  • Verify relationships between physicians who order a large volume of DMEPOS equipment or supplies or home health (HH) visits and the intended beneficiaries.

The new RACs will start educating and informing providers later this month and in November about the program, CMS said. You’ll find scheduling information about these meetings on the CMS RAC Web site.

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