Arent Fox partner Connie Raffa will be leading a seminar on RAC Audits. As part of the new Medicare Integrity Program, Congress has authorized CMS to contract with private entities as Recovery Audit Contractors (RACs). There are four RACs each responsible for conducting automated (data mining), and complex (medical review) audits of all fee-for-service providers and suppliers under Medicare Part A & B. RACs will review a percentage of claims, depending on provider/supplier type, going back 3 fiscal years from the date of service, but not any claims with dates of service before October 1, 2007. RACs can determine overpayments based on statistical samplings. RACs will authorize recoupments against pending Medicare remittances by MACs, FIs and Carriers. RACs are rewarded a percentage of recoupments collected. There are appeal rights. However, stay of recoupments are limited to the first two levels of appeal and only under certain circumstances. Interest is never stayed.

Learn more about RACs, and how to prepare your company so that your audit won’t result in a significant overpayment.