The mission of the RAC is to provide CMS with a mechanism to identify past improper payments as well as a tool to prevent future overpayments and or underpayments made to providers and suppliers in the Medicare Fee-For-Service Program. Developed by The Centers for Medicare and Medicaid Services in 2005, the Recovery Audit Contractor (RAC) program is the outgrowth of a successful demonstration program used as a cost effective means to ensure that correct payments are being made to providers and suppliers in the Medicare Fee-For-Service Program. Section 302 of the Tax Relief and Health Care Act of 2006 makes the 3-state trial RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than January 1, 2010. See below for links to the text of this legislation and other related information. The program is administered by 4 regions.  

On October 6, 2008, CMS announced the names of the new national RACs. The RAC in each jurisdiction (region) is as follows:

• Region A:  Diversified Collection Services (DCS) -1-866-201-0580,  initially working in Maine, New Hampshire, Vermont,  Massachusetts, Rhode Island and New York. 
• Region B:  CGI -1-877-316-7222, e-mail: racb@cgi.com, initially working in Michigan, Indiana and Minnesota.
• Region C:  Connolly Consulting, Inc. -1-866-360-2507, in Region C, initially working in South Carolina, Florida, Colorado and New Mexico.

• Region D:  HealthDataInsights, Inc.-Part A: 866-590-5598, Part B: 866-376-2319, e-mail: racinfo@emailhdi.com, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona.

Additional states will be added to each RAC region in 2009. PRG-Schultz, Inc. will serve as a subcontractor to HDI, DCS and CGI in regions A, B and D.  Viant Payment Systems, Inc. will serve as a subcontractor to Connolly Consulting in region C.  Each subcontractor has negotiated different responsibilities in each region, including some claim review.   

• Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb] 
• Map of Future RAC Jurisdictions [pdf, 154kb] 
• RAC Expansion Schedule [pdf, 61.0kb] 
• Recovery Audit Contractor (RAC) Program Slide Presentation [pdf, 56.95kb] 
• 2008 RAC Fact Sheet
• Frequently Asked Questions

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Downloads

• Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb] 
• Map of Future RAC Jurisdictions [pdf, 154kb] 
• RAC Expansion Schedule [pdf, 61.0kb] 
• Recovery Audit Contractor (RAC) Program Slide Presentation [pdf, 56.95kb] 

Related Links Inside CMS

• 2008 Press Release Announcing New National RACs
• 2008 RAC Fact Sheet
• Frequently Asked Questions
• Get Recovery Audit Contractor (RAC) e-mail updates
• CR 6183 Limitation on Recoupment (935) [pdf, 420kb] 
• MM 6183 Limitation on Recoupment (935) [pdf, 420kb] 
• MLN The Medicare Appeals Process Brochure [pdf, 1.23mb] 
• Appeals Process Diagram [pdf, 15.10kb] 

Related Links Outside CMS

• Final RFP (and Statement of Work) for 4 new permanent RACs

Source: http://www.cms.hhs.gov/RAC/