The Medicare Recovery Audit Contractor Program (“RAC”) program has been made permanent and is expanding nationwide, pursuant to Section 302 of the Tax Relief and Health Care Act of 2006. Medicare providers and suppliers in Michigan are some of the first in the country that will experience RAC audits and potential claim denials. Pursuant to CMS’s most-recently published “Phase In Schedule,” the RAC program expanded to Michigan March 1, 2009.
CGI Technologies and Solutions, Inc. (“CGI Technologies”) is the RAC assigned to “Region B” – an area of the nation comprised of Michigan, Indiana and Minnesota. Before CGI Technologies begins auditing, on April 10, 2009, it will conduct a webinar presented by the Michigan State Medical Society. The purpose of the webinar is to provide education regarding RAC audits and RAC processes to Medicare providers and suppliers that may be soon subject to RAC audits. The webinar will be held from 9 a.m. to 12 p.m. EST.
The goals of the RAC program are to identify and correct improper Medicare payments made to providers. RACs are compensated on a contingency-fee basis, based upon the principal amount collected from and/or returned to Medicare providers and suppliers. Thus, the RACs are highly incentivized to identify improper payments. CMS advises, on its website, that before RAC auditing begins, providers and suppliers should ensure that submitted claims meet Medicare rules. For more information on the RAC program, please click here.
A qualified healthcare attorney can assist your entity to adopt and implement effective billing compliance policies and procedures, and can assist your entity should it be faced with a RAC audit or claim denials. For more information, please call Abby Pendleton, Esq. or Jessica L. Gustafson, Esq., Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. at (248) 996-8510, visit The HLP website’s RAC, Medicare and Other Payor Audits page, or visit The HLP website.