CMS Issue Proposed Rules for Medicaid Recovery Audit Contractors - November 11, 2010

The federal Centers for Medicare & Medicaid Services (CMS) on Nov. 5 issued a proposed rule to implement the Affordable Care Act’s Medicaid Recovery Audit Contractor (RAC) provisions. Under the Affordable Care Act, states must submit state plan amendments that govern the establishment of Medicaid RACs to CMS by Dec. 31, 2010. States then have until April 1, 2011, to implement the program, which is designed to limit waste, fraud and abuse. The Medicaid RAC program is based on the existing Medicare RAC program, although states will have some flexibility in how they administer the Medicaid program. Like Medicare RACs, Medicaid RACs also will be paid on a contingency-fee basis. Comments on the proposed rule are due by Jan. 10, 2011.