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Recovery Audit Contractor

Recent Updates

04/23/10: CMS Announces a National Call on Section 935 Limitation on Recoupment. The call details are as follows: May 26, 2010 1:30pm - 3:30pm EST: Nationwide Section 935 Limitation on Recoupment Call for all Providers, 1-800-603-1774, meeting ID: 70868130. *This is not a RAC specific call. 

See below for the 935 Limitation on Recoupment Slide Presentation.

04/06/10: CMS Announces Series of Nationwide RAC 101 Calls. The subject matter of the RAC conference calls will be RAC 101. They will be presented by CMS staff. The content on each call will not change drastically. The RAC operational process will be discussed and there will be a question and answer session held at the end. The information presented will not be drastically different from other RAC 101 sessions that were held in the past in conjunction with the hospital and/or medical associations. These calls offer another opportunity for providers who missed the earlier presentations to hear the RAC 101 session and to ask any questions they may have regarding the RAC process. Registration is not required for the calls. 

April 28, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call, 1-877-251-0301, meeting ID: 66532244

May 4, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for Home Health and Hospice Providers, 1-877-251-0301, meeting ID: 66524952

May 5, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for DMEPOS, 1-877-251-0301, meeting ID: 66527260

May 12, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for Physicians, 1-877-251-0301, meeting ID: 66529242

June 10, 2010 1:00pm- 2:30pm EST: Nationwide RAC 101 Call, 1-800-603-1774, meeting ID: 76722913

See below for the RAC 101 Slide Presentation.

01/29/10: CMS Expands FY 2010 RAC ADR limits to all Institutional Providers. Click the link below to review the additional documentation limits for fiscal year 2010. The limits announced in December 2009 applied only to requests for DRG validation purposes; the same methodology will now be used for reviews of all institutional claim types. CMS will post the limits for physicians, non-physicians practitioners and DMEPOS suppliers at a later date. 

06/24/09 CMS Releases a RAC Review Phase-in Strategy. Click the link below to view the schedule.

12/12/08: Questions about a RAC Demonstration Claim. If you have a question on a claim reviewed by a RAC during the RAC demonstration please e-mail CMS at the following address: RAC@cms.hhs.gov. Please do not send personal health information to this e-mail address. Thank you.

10/10/08: CMS Announces RAC Contingency Fee Percentages. The RACs are paid a contingency fee; that is, the RACs receive payment based on the amount of the improper payments they correct for both overpayments and underpayments. Each RAC's contingency fee is established during contract negotiations with CMS and, as such, the contingency fee varies for each RAC. Click the link below to view the RAC contingency fees.

10/9/08: CMS Hires RAC Validation Contractor. CMS is pleased to announce it has contracted with Provider Resources, Inc, of Erie, PA, to work as the Recovery Audit Contractor (RAC) Validation Contractor.  The RAC Validation Contractor (RVC) will work with CMS and the RACs to approve new issues the RACs want to pursue for improper payments, as well as perform accuracy reviews on a sample of randomly selected claims on which the RACs have already collected overpayments.  The RVC is another tool CMS will use to provide additional oversight and ensure that the RACs are making accurate claim determinations in the permanent program.


Downloads
Slides for Section 935 Recoupment Presentation [PDF, 198 KB]

Slide Presentation for RAC 101 Calls [PDF, 107 KB]

Provider Options Chart [PDF, 16.20 KB]

FY 2010 RAC ADR Limits for All Institutional Providers [PDF, 22.17 KB]

CMS RAC Review Strategy [PDF,151.66 KB]

MLN Matters Article [PDF, 77.2 KB]
Related Links Inside CMS

Related Links Outside CMSExternal Linking Policy

RAC Contingency Fee Percentages

RAC 101 YouTube Presentation

 

Page Last Modified: 06/16/2010 2:54:20 PM
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