Medicaid RACs May Have Different Standards Than Medicare RACs

Although few details have been available on Medicaid Recovery Auditors, or RACs, since CMS posted a final rule in 2011, new information is starting to seep out, according to a recent blog post from Paul Spencer, compliance officer for Fi-Med Management and author of The RAConteur.

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Medicaid RACs went live in January 2012, and Mr. Spencer said he has learned of new developments within the program.

Most notably, he said sources have told him Medicaid RACs will not reimburse hospitals and other providers for medical records, though Medicare RACs do. In addition, Mr. Spencer said Medicaid RACs are not required to publish an “approved issues list,” which is a CMS-approved document of approved audit issues.

“Even if a provider has seen no Medicaid RAC activity as of yet, I must insist that the Medicaid RAC statement of work in your state be reviewed thoroughly,” Mr. Spencer wrote. “Know your RAC contractor, and begin a dialogue.”

More Articles on Medicaid RACs:

What are Medicaid RACs’ Biggest Targets?
RACs and Other Audits: 2011 in Review and Attractions Ahead
CMS Releases FAQs on Medicaid RACs

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