Case Management

Mentor moment: Medicaid RACs are coming...someday

Case Management Weekly, March 2, 2011

CMS has instructed Medicaid agencies to develop Medicaid recovery audit contractor (RAC) programs; however, the implementation date remains unknown.  

CMS sent an October 2010 letter to state Medicaid directors, requiring state agencies to submit their plans for RAC implementation or request an exemption. CMS also said in the letter that it expects the Medicaid RAC programs to be fully implemented by April 1, 2011. However, a February bulletin has suspended that deadline indefinitely.

The bulletin states that the April 1 deadline did not give state agencies enough time to address operational issues to ensure compliance with provisions of the final rule, which is yet to be published. CMS plans to issue the final rule later this year and will indicate the new implementation deadline at that time.

In the meantime, you can find out which states have submitted their Medicaid State Plan amendment (SPA) to CMS, at the CMS website. SPAs address the essential elements of the state’s RAC program. To date, all U.S. states and territories have submitted SPAs.

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