One of the rules, which the Department of Health and Human Services sent to the OMB, is designed to guide states in funding start-up, operation and maintenance of Medicaid RACs. The rule would require states create adequate appeals processes and coordinate activities with existing Medicaid audit contractors.
The other rule would disallow Medicaid federal payments to states for “any amounts expended for providing medical assistance” for healthcare-acquired conditions, but would maintain Medicaid beneficiaries’ access to care and services, according to the report.
Read the Health Data Management report on the two final rules for recovery audit contractors programs and Medicaid payments.
Related Articles on RACs:
RACTrac Results Show Error-Prone RACs
A Primer on Audits by RACs MACs, ZPICs and CERTs
RACs Focusing on One-Day Stays, RACTrac Survey Reports
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