Section 6411(a)(1) of the Affordable Care Act (ACA) requires states to establish a program under which the state contracts with one or more recovery audit contractors for the purpose of identifying underpayments and overpayments and recouping overpayments. Under ACA, states are required to establish their Medicaid RAC programs by December 31, 2010, via the state plan amendment process. In the proposed rule implementing the ACA provision, CMS required state to implement their Medicaid RAC programs by April 1, 2011.
Subsequently, CMS issued a letter to the states delaying the implementation date. In a Center for Program Integrity (CPI) CMS Informational Bulletin, CPI –B 11-03, February 1, 2011, CMS indicated that out of consideration for state operational issues and to ensure that states comply with the provisions of the final rule (yet to be issued), CMS determined that states will not be required to implement their RAC programs by the proposed implementation date of April 1, 2011. Instead, when the final rule is published, it will indicate the new implementation deadline. CMS anticipated that the final rule would be issued later this year.
As of now, all states have submitted state plan amendments pertaining to Medicaid RACs. 10 States have asked for an exemption and all 5 US Territories. These states are: Alaska, Arizona, Kansas, Louisiana, Maryland, Minnesota, Montana, South Dakota, Texas, and Wyoming. Click here to access the CMS Medicaid RAC Map.
As with AHCA’s Medicare RAC site we will update this web site on a continual basis.
Resources
AHCA RAC ContactsIf you have any questions or need assistance, your RAC team at AHCA is:
Dianne De La Mare: ddmare@AHCA.org
Peggy Connorton: pconnorton@ahca.org
Elise Smith: esmith@ahca.org