I like information that is easily proved. In the world of today where information is at one’s fingertips, it is with great irony that correct information is becoming hard to find. For those of you who like things easy, let me assure you that Wikipedia is not the only trusted source of information.
Which brings me to the Medicaid RAC program. Every state and territory has submitted a state plan amendment to add recovery audit contractors to their Medicaid plans. The obvious next question is what entities they have contracted with to perform these services.
First, I looked at the paperwork. I reviewed the state plan amendments that were submitted by the states (available here for review using the correct search parameters). The forms that were filled out by the states consisted solely of agreeing to contract with RACs for the state plans, and included no information whatsoever regarding who would get the contracts. I punished myself by insisting on reading these documents for all states available for viewing, and came up with a miss.
Next, I went to state Medicaid sites to determine who the RACs might be. Some sites offered links to their state plan amendments, and we all know from the previous paragraph how enlightening a discovery that was. I did searches on these same websites consisting either of the phrase ”recovery audit contractors” or simply “RAC” and I was directed in most cases to a blank page with no results and in some cases to (you guessed it) the state plan amendment that was filed with CMS.
As a follow-up, I did the tried and true web search, hoping that someone out in the hinterlands has compiled this information for public perusal. This last road was littered with a series of dead ends.
Lastly, as my final attempt, I used some inside knowledge. I know of two states who have finalized contracts to provide Medicaid RAC services. One of the those two states has contracted with an existing Medicare RAC contractor which shall remain nameless. I sent an e-mail to this contractor, the exchange of which (edited to exclude the name of the contractor) is below:
Question: “I have come to understand that (redacted) will be providing recovery audit services for state Medicaid plans. Can you tell me with which states (redacted) has finalized contracts to provide these services? I eagerly await your reply.”
Answer: “As far as we are aware at (redacted) Provider Services there has been no official announcement made by CMS. Feel free to contact us in the future or you can monitor the CMS website for the announcement. Thank you.”
Roughly translated, this answer means “none of your business”. I’m fluent in Brush-Off.
We remain several months away from a final rule for Medicaid RACs from CMS. I was told in mid-February by Angela Brice-Smith, the director of the Medicaid Integrity Group at CMS, about a “transparency initiative” that would reveal the RAC contractors for each state. I was also told that I would be included on a “tickle list” for info on Medicaid RACs. It has now been nearly three months since I received that e-mail and I haven’t had so much as a cootchy-cootchy-coo from CMS on this topic.
With only North Dakota, Wyoming, Louisiana and the District of Columbia left waiting for their state plan amendments to be accepted by CMS, it makes very little sense for this initiative to begin at any other time other than immediately. If the states won’t tell me, and the contractors who have signed on won’t tell me, there’s only one entity left.
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