Join, Follow & Connect
Join Modern Healthcare's LinkedIn group Follow Modern Healthcare on Twitter Join Modern Healthcare's Facebook group Follow Modern Healthcare's Pinterest board Modern Healthcare's Flickr page Modern Healthcare's YouTube Channel Get a Modern Healthcare news feed

 
Comment Buy Reprints Print Article Share on LinkedIn Share on Facebook Share on Twitter Email this page to a colleague
Healthcare Business News
 

Proposed rule offers states pay options for Medicaid RACs


By Jessica Zigmond
Posted: November 5, 2010 - 6:00 pm ET
Tags:

In a proposed rule regarding new Medicaid recovery audit contractors, the CMS said states will be allowed to determine whether to pay their Medicaid RACs on a contingency basis or under some other fee structure that identifies underpayments.

Advertisement | View Media Kit

 

This year's Patient Protection and Affordable Care Act requires states to establish Medicaid RAC programs by submitting state plan amendments to the CMS by Dec. 31. The proposed regulation also highlights the requirements that states must meet, and the federal contribution that CMS will provide to help in funding state RAC programs. Under the regulation, a state may use its current administrative appeals process or may change its process for appeals related to Medicaid RACs.

“All fees paid to the Medicaid RACs must come from amounts recovered after all available appeals have been exhausted,” the agency said in its announcement. The rule also proposes that states and Medicaid RACs coordinate with other contractors and entities auditing Medicaid providers and with state and federal law enforcement agencies.

Search ModernHealthcare.com:


 

Switch to the new Modern Healthcare Daily News app

For the best experience of ModernHealthcare.com on your iPad, switch to the new Modern Healthcare app — it's optimized for your device but there is no need to download.