Home Health & Hospice

Medicaid Recovery Audit Program Launched

Homecare Insider, October 3, 2011

The Centers for Medicare and Medicaid Services (CMS) released the Medicaid recovery audit contractors (RACs) final rule on September 15. In February, CMS delayed its expected April 1 implementation date and announced that it would be released later in the year.

This program, created by the Affordable Care Act (ACA), will help identify and recover improper Medicaid payments and is similar to the Medicare Recovery Audit Program, which homecare providers are familiar with. This program is funded largely by paying independent auditors a contingency fee out of improper payments that they recover.

RACs will review post-payment claims and will go back three years from the date claims were paid. Like the Medicare program, RACs are required to employ nurses, therapists, certified coders, and a physician.

Click here to access the Medicaid RACs final rule.