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Medicaid Recovery Audit Contractor (RAC) contracts have been awarded to 26 states by the Centers for Medicare and Medicaid Services (CMS). A quarter of the 26 states with Medicaid RACs have begun reviewing claims, with some just beginning and some further along in the process.
CMS will begin collecting performance metrics for the Medicaid Recovery Audit Contractor program later this year. CMS has allowed temporary exceptions for all the territories and for some states with a low Medicaid Payment Error Measurement Rate (PERM). The information will be available to the public by winter.
The remaining states either have not yet been awarded a Recovery Audit Contractor contract or have been granted a limited exception to the RAC requirement.
The Medicaid Recovery Audit Contractor program was established by Section 6411 of the Patient Protection and Affordable Care Act, with the intent of identifying underpayments and overpayments within the Medicaid program and recovering the overpayments.
For more information, you can visit CMS Medicaid RACs At-a-Glance, which shows the RACs for each state, including contact information.