What's the Status of Medicaid RACs?
The Medicaid Recovery Auditor program officially started this past January, and according to a recent blog post from Paul Spencer, compliance officer for Fi-Med Management and author of The RAConteur, there has been little recognition of the Medicaid RACs' progress mostly because there hasn't been much to report.
According to two sources, Medicaid RACs have initiated audits in three states: Connecticut, Kansas and New Jersey. The types of issues under RAC review were not disclosed, but Mr. Spencer said the common denominator of all three states is their Medicaid RAC company, HMS. HMS is the official Medicaid RAC for Connecticut and New Jersey, and HDI — a subsidiary of HMS that was purchased in November last year — is the Medicaid RAC for Kansas.
Mr. Spencer said he expects other states with HMS as their Medicaid RAC, such as New York and Pennsylvania, to see more activity in the near future, but there still remains a large swath of states that do not have Medicaid RAC solutions finalized.
"Clearly, with so many states not mentioned…it is safe to say that the balance of the states is operating in an eerie silence as the provider community awaits first contact with the Medicaid RAC process," Mr. Spencer wrote.
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