Outpatient Facility Coding Alert - 2008 Issue 11
RACs: Recovery Audit Contractors Collect $371.5 Million
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Article Overview
This article discusses the Medicare Recovery Audit Contractor (RAC) program, CMS-reported recovery totals, and the broader controversy surrounding RAC audits in several states. It is useful for healthcare providers, compliance staff, revenue cycle teams, and coding professionals who want a high-level understanding of audit activity, program expansion, and related legislative concerns.
Why This Topic Matters
RAC activity can affect Medicare compliance, payment integrity, and audit preparedness for providers and billing organizations. The article also highlights policy and implementation issues that may influence how audit programs are received and managed.
What You Will Learn
- What the RAC program is and why it has drawn attention
- Which states were involved in the demonstration program described
- How CMS characterized the program’s payment recovery results
- What policy concerns and legislative responses were raised in relation to the program
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Compliance professionals
- Healthcare administrators
- Revenue cycle teams
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