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01/29/10: CMS Expands FY 2010 RAC ADR limits to all Institutional Providers. Click the link below to review the additional documentation limits for fiscal year 2010. The limits announced in December 2009 applied only to requests for DRG validation purposes; the same methodology will now be used for reviews of all institutional claim types. CMS will post the limits for physicians, non-physicians practitioners and DMEPOS suppliers at a later date. 12/02/09: CMS Announces RAC DRG Validation ADR limits for FY 2010. Click the link below to review the additional documentation limits for fiscal year 2010. These limits will apply to DRG Validation only. CMS will post the limits for all other reviews at a later date. 06/24/09 CMS Releases a RAC Review Phase-in Strategy. Click the link below to view the schedule. 12/12/08: Questions about a RAC Demonstration Claim. If you have a question on a claim reviewed by a RAC during the RAC demonstration please e-mail CMS at the following address: RAC@cms.hhs.gov. Please do not send personal health information to this e-mail address. Thank you. 11/04/08: Protest of RAC Awards and Automatic Stay The Centers for Medicare & Medicaid Services (CMS) is required to impose an automatic stay in the contract work of the four Recovery Audit Contractors (RAC) program. This action is the result of protests filed by two unsuccessful bidders for the RAC program with the Government Accountability Office (GAO). An automatic stay will stop work for all four RAC regional awards until a determination is made by GAO, as required under provisions of the Competition and Contracting Act of 1984 (CICA). Under the CICA, GAO has 100 days to issue its decision, which means a decision would be due for these protests in early February. The four RAC contracts – and any work under those contracts – are on hold pending the outcomes of the protests.
10/31/08: CMS Begins Provider Outreach in the 1st Wave States.
10/10/08: CMS Announces RAC Contingency Fee Percentages. The RACs are paid a contingency fee; that is, the RACs receive payment based on the amount of the improper payments they correct for both overpayments and underpayments. Each RAC's contingency fee is established during contract negotiations with CMS and, as such, the contingency fee varies for each RAC. Click the link below to view the RAC contingency fees.
10/9/08: CMS Hires RAC Validation Contractor. CMS is pleased to announce it has contracted with Provider Resources, Inc, of Erie, PA, to work as the Recovery Audit Contractor (RAC) Validation Contractor. The RAC Validation Contractor (RVC) will work with CMS and the RACs to approve new issues the RACs want to pursue for improper payments, as well as perform accuracy reviews on a sample of randomly selected claims on which the RACs have already collected overpayments. The RVC is another tool CMS will use to provide additional oversight and ensure that the RACs are making accurate claim determinations in the permanent program.
Page Last Modified: 01/29/2010 9:21:09 AM
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