Advanced Search

Pediatric Coding Alert

News You Can Use:

Medicaid Will Implement RAC Audits Jan. 1, CMS Says

Published on Mon Oct 03, 2011

Recent delays have given you more time to prepare. You've benefited from several delays in Medicaid RAC audits, but as of Jan. 1, 2012, the time will finally come when those audits will kick in. As we reported in Vol. 14, No. 4 of Pediatric Coding Alert, "recovery audit contractors" (RACs), which the federal government has hired to audit physician claims, will be reviewing Medicaid claims soon thanks to last year's Patient Protection and Affordable Care Act. Although RAC audits were originally slated to impact Medicaid claims on April 1, 2011, CMS delayed that date, and did not make a subsequent announcement until Sept. 14, at which point the Federal Register posted a final rule indicating the audits will begin on Jan. 1, 2012. In place for Medicare contractors since 2005, RACs are often referred to as medical "bounty hunters" because they only make money if they collect overpayments from [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pediatric Coding Alert

View All