Long-Term Care

New Recovery Audit Contractor program FAQs

Billing Alert for Long-Term Care, August 1, 2009

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CMS recently updated its Web site to include new FAQs about the Recovery Audit Contractor (RAC) program. The following are several of the new FAQs, which have been adapted from the CMS Web site.

Why is CMS using RACs?

Section 306 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 required CMS to complete a demonstration project to show the use of RACs in identifying underpayments and overpayments and recouping overpayments under the Medicare program for services for which payment is made under Part A or B of title XVIII of the Social Security Act.
The demonstration operated from March 2005 through March 27, 2008. Section 302 of the Tax Relief and Health Care Act of 2006 required the U.S. Department of Health and Human Services to make the RAC program permanent and nationwide by no later than January 1, 2010.
CMS is planning a gradual expansion to all 50 states. The expansion schedule can be viewed at www.cms.hhs.gov/RAC.

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