CMS proposes regulations for Medicaid RACs

The Centers for Medicare and Medicaid Services has proposed new rules for recovery audit contractors (RAC news) regarding their audits of Medicaid payments, a change intended to make the process similar to the way it is conducted for Medicare payments.

The Affordable Care Act, signed into law earlier this year, requires all states to hire Medicaid RACs. States may opt out, but such a circumstance is highly unlikely, according to RAC Monitor. States have until Dec. 31 to submit their RAC policy as part of an amendment to their state plans for operating their Medicaid programs.

"Reducing improper payments is a key goal of the Administration, and the tools provided by the Affordable Care Act will help us achieve that goal," CMS Administrator Donald Berwick said in a statment. "We are using many of the lessons that we learned from the Medicare RAC program in the development and implementation of the Medicaid RACs, including a far-reaching education effort for healthcare providers and State managers."

CMS is currently taking public comments on the regulations, which are expected to go into effect on April 1. It issued preliminary guidance on the Medicaid RAC issue last month. The proposed regulations hew closely to the guidance, according to Becker's Hospital Review.

For more:
- read The Hill article
- read the RAC Monitor article
- read the Becker's Hospital Review article

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