RAC expands to State Medicaid Program

Through an Oct. 1 letter to State Medicaid Directors, Peter Budetti, Deputy Administrator for the Center for Medicare and Medicaid Services (CMS), provided initial guidance on the implementation of the  Recovery Audit Contractor
(RAC) programs by State Medicaid agencies.

Section 6411 of the Affordable Care Act, calls for the expansion of the RAC Program by requiring States to establish programs to contract with RACs to audit payments to Medicaid providers by December 31, 2010.   According to Mr. Budetti’s letter, States are expected to “fully implement their RAC programs by April 1, 2011.”   In the upcoming months, CMS will be issuing regulations providing additional guidance to the States.

Recovery Audit Contractor program in the states