RAC Contracts Extended to End of 2015

WASHINGTON (Feb. 26, 2014)—Because of the contract cycle, Feb. 21 was the last day a recovery auditor contractor (RAC) could send a post-payment additional documentation request (ADR) to providers. However, CMS has extended the current contracts through Dec. 31, 2015, to provide a transitional period in which the RACs can complete all outstanding claim reviews and other processes by the end date of their contracts. During the transition period, CMS will also continue to refine and improve the RAC program as they did several years ago. For example, the agency is reviewing ADR limits, timeframes for review, and communications between auditors and providers. CMS is making a number of changes to the RAC program in response to industry feedback including letters and comments from AAHomecare, as well as meetings with the association. The agency believes these changes will improve accuracy, reduce provider burden and increase program transparency. These changes will be effective with the next contracts. For more information on these specific changes, click here. Providers should make note of these two important dates: February 28—last day a Medicare audit contractor (MAC) may send pre-payment ADRs for the Recovery Auditor Prepayment Review Demonstration June 1—last day a RAC may send improper payment files to the MACs for adjustment Providers should be aware that automated RAC audits will continue until June 1. Only complex reviews will end as of Feb. 28. CMS is currently in the procurement process for the next round of contracts, which they will award in 2014. The agency has redrawn jurisdiction maps, but still plans to contract with one national DME and home health/hospice, and four A/B recovery auditors. The four existing contractors are: Region A – Performant Recovery Region B – CGI Federal Region C – Connolly Region D – HealthDataInsights CMS will update their website with more information on the contract procurement and awards process as it becomes available. Providers should contact RAC@cms.hhs.gov with any questions.