RACs: Get Up to Speed on New RAC Contracts, Plans for 2014

Why This Topic Matters

RAC activity can affect claim review exposure, appeal management, and compliance planning for Medicare providers. Understanding how CMS is structuring audits helps organizations prepare for changing oversight and documentation demands.

Article Sections

1. CMS contract delay and RAC program status

   Summarizes the status of the Recovery Audit contract cycle and CMS actions related to the program transition. It also frames the broader context for changes being discussed in the article.

2. Program changes and provider concerns

   Describes planned changes to the audit process and reflects provider concerns about how the program operates. The section focuses on the policy and operational context rather than case-specific details.

3. Cover Your Bases Before Things Get ‘Complex’

   Introduces the distinction between general review categories used in the audit program and explains why providers are being advised to stay attentive during the transition. It also points to CMS guidance and related background material.

4. Watch for

   Highlights areas that may receive attention in future review activity and notes examples of subject areas currently under audit focus. The section is oriented toward anticipating potential audit emphasis.