Health Information Management

Understand RAC medical record request limitations

HIM-HIPAA Insider, November 18, 2008

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Regardless of the fact that CMS announced November 3 that it would delay all recovery audit contractor (RAC) activity until further notice, it’s important continue preparations for a national rollout, including bracing for a large volume of medical record requests. The good news for providers is that CMS announced several limitations on the number of medical records RACs could request. For example, RACs can only request 10% of the average monthly Medicare claims (maximum of 200) every 45 days in the following settings:

  • Inpatient hospitals
  • Inpatient rehabilitation facilities
  • Skilled nursing facilities
  • Hospices

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