Medicaid Unveils RACs-at-a-glance Website

Most auditors will tell you that keeping track of Medicaid recovery audit contractor (RAC) efforts is more complicated than in the Medicare program since states are involved. That is why the Centers for Medicare & Medicaid (CMS) is unveiling its new Medicaid Audit Contractor RACs-at-glance website.

CMS provides guidance to states as they implement their Medicaid RAC programs, monitor the progress of those programs, and encourage states to make their RAC programs as transparent as possible. The new on-line tool, CMS said, will help make that easier for providers, payers, and others. The new website uses a state map to allow users access to information about each state’s program, each state’s
RAC vendor and medical director, contact information for the state program integrity director, and charts and data.

State Medicaid agencies contract with RACs to identify and recover overpayments and identify underpayments made to Medicaid providers. The Medicaid RAC final rule, 42 CFR §§ 455.500 et seq., implemented section 6411(a) of the Affordable Care Act, and  required states to implement Medicaid RAC programs by January 1, 2012. Section 455.516 of the final rule allows flexibility for states to request exceptions to the final rule provisions by submitting a State Plan Amendment (SPA) for CMS review and approval, and five  states ( Arkansas, Illinois, Maryland, Michigan, and Utah) have not implemented a Medicaid RAC program yet.   More information on the Medicaid RAC program can be found on the CMS website.

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