Mr. Spencer said Medicaid RACs, which officially started January 2012, appear to be targeting coverage and payment issues first, which is similar to Medicare RACs.
“As an example, in one state, if a state Medicaid agency has made a payment at a time when the patient was covered by a Medicaid HMO, they are requesting money back from the providers,” Mr. Spencer wrote. “Given that the RACs can go back three years to identify such claims, timely filing issues rise to the surface in a rather stark fashion.”
He also said incorrect Part B coinsurance payments are in the crosshairs. Because Medicaid programs vary from state to state, other areas may eventually pop up depending on how payment claims are interpreted.
More Articles on Medicaid RACs:
What’s the Status of Medicaid RACs?
Medicare, Medicaid RACs Send Mixed Financial Results for HMS
CMS Releases FAQs on Medicaid RACs
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