decisionhealth Newsletters, Part B News - 2007 Issue 5 (May)
RACs: Controversial auditors may grow by 3 states soon
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Article Overview
This article reviews CMS plans to expand the Recovery Audit Contractor (RAC) demonstration beyond the states already participating and toward broader national implementation. It discusses the timeline for expansion, the contracting process, regional organization, and the addition of medical directors as part of program requirements. The piece is relevant to providers, compliance teams, and coding professionals watching Medicare audit activity and administrative changes.
Why This Topic Matters
The planned growth of RAC activity affects Medicare claim review oversight, audit exposure, and operational preparedness for providers across more states. Understanding the timing and structure of the program helps stakeholders anticipate changes in audit activity and administrative requirements.
Article Sections
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National expansion plans
Covers the planned broader rollout of the RAC program and the timeline discussed for additional states and nationwide demand-letter activity.
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Current demonstration and contractor process
Summarizes the states already included in the demonstration, the anticipated addition of more states, and the upcoming request-for-proposal and contract process.
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Program structure and oversight
Describes how the program is being organized regionally and the requirement for medical directors within the contracting framework.
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Views on the RAC program
Includes commentary on the purpose and perceived impact of the program from a CMS-related perspective.
What You Will Learn
- How CMS is structuring the expansion of the RAC program
- What administrative milestones are associated with the broader rollout
- What oversight and staffing elements are being added to the program
- How the article frames the program’s impact on Medicare administration
Who Should Read This
- Medical coders
- Compliance professionals
- Revenue cycle staff
- Healthcare administrators
- Physician practice managers
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