CMS panel begins studying, approving RAC audit targets

Why This Topic Matters

Understanding which RAC audit targets are being reviewed or approved helps providers and billing teams anticipate compliance risks and monitor areas that may trigger audits or record requests. The article is useful for organizations following CMS oversight activity and the evolving focus of Recovery Audit Contractors.

Article Sections

1. CMS review process for RAC audit targets

   Explains how CMS receives, reviews, and approves proposed audit targets from Recovery Audit Contractors. It also notes the timing of public posting and approval status.

2. Examples of audit areas under review

   Summarizes several broad claim categories being considered in the CMS review process, including physician claim issues and hospital billing scenarios. The section outlines the general types of payment concerns involved without giving coding instructions.

3. RAC public posting and audit activity timing

   Describes when approved targets are posted and when RACs may begin sending demand letters and record requests. It also clarifies that not all targets must be approved before audit activity starts on already approved items.