Recovery Audit Contractor Program
Recovery Audit Program (RAC)
Christina W. Furbert
Devry University
HIT230 Health Insurance and
Reimbursement
Professor Ingram
Table of Contents
What is RAC?..............................................................................................................................................................3
What type of audits will the RAC program cover?.....................................................................................................3
What could happen if it is discovered by RAC that health care organization may be committing fraud? Is there an appeal process?...........................................................................................................................................................4
What could happen if it is discovered by RAC that health care organization may be committing fraud? Is there an appeal process?..............................................................................................................................................................4
Why is RAC important to my organization?................................................................................................................5
How can my organization prepare for RAC………………………………………………………………………….5
What is RAC? In 2003, the Federal government started a demonstration project called the Recovery Audit Contractor program (RAC), this program was first implemented in six States to help identify and recover funds that were overpaid to health care Federal Medicare/Medicaid program.(Georgia Medicaid RAC) In 2006, the Tax Relief and Health Care Act made the Medicare RAC program a permanent fixture, and the program was expanded to cover all 50 states. In 2010, the Patient Protection and Affordable Care Act (ACA) enacted a provision requiring that each state establish a Medicaid RAC program for its state Medicaid program. Today the RAC program is divided into four regions, with one Medicare RAC servicing each
Christina W. Furbert
Devry University
HIT230 Health Insurance and
Reimbursement
Professor Ingram
Table of Contents
What is RAC?..............................................................................................................................................................3
What type of audits will the RAC program cover?.....................................................................................................3
What could happen if it is discovered by RAC that health care organization may be committing fraud? Is there an appeal process?...........................................................................................................................................................4
What could happen if it is discovered by RAC that health care organization may be committing fraud? Is there an appeal process?..............................................................................................................................................................4
Why is RAC important to my organization?................................................................................................................5
How can my organization prepare for RAC………………………………………………………………………….5
What is RAC? In 2003, the Federal government started a demonstration project called the Recovery Audit Contractor program (RAC), this program was first implemented in six States to help identify and recover funds that were overpaid to health care Federal Medicare/Medicaid program.(Georgia Medicaid RAC) In 2006, the Tax Relief and Health Care Act made the Medicare RAC program a permanent fixture, and the program was expanded to cover all 50 states. In 2010, the Patient Protection and Affordable Care Act (ACA) enacted a provision requiring that each state establish a Medicaid RAC program for its state Medicaid program. Today the RAC program is divided into four regions, with one Medicare RAC servicing each