Corporate Compliance

State-by-state differences for Medicaid Recovery Audit Programs

Compliance Monitor, April 4, 2012

While many of the administrative and organizational efficiencies that providers currently use to protect against other government auditors will help, there are a number of marked differences between the two programs.

First and foremost is that each state will be set up differently. "This is going to be interesting to say the least, so providers will need to pay particular attention to any guidance released on this program," says Elizabeth Lamkin, CEO, Pace Healthcare Consulting in Hilton Head, SC.

"Providers will need to be especially proactive when it comes to the Medicaid RAC process because the statement of work is so much more vague than the Medicare [Recovery Auditor Program] statement of work," she says. "Though it says that it's modeled after the Medicare statement of work; every state really has the freedom to customize its own program, including the appeals process, different timelines, and the amount of issues they will look at, and so on."

Read more on HealthLeaders Media website.

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