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CMS Publishes Guidance on Medicaid RAC Program

January 11, 2012

Authors: Joan W. Feldman, Vincenzo Carannante, William J. Roberts

Since our December 15, 2011 presentation on the Medicaid Recovery Audit Contractor program, CMS has published answers to frequently asked questions concerning the Medicaid RAC program.  The FAQs provide general information about the program as well as additional operational guidance to states establishing their Medicaid RAC programs.   In addition, CMS has also recently published a two page notice indicating that since CMS increased contingency fees paid to Medicare RACs for recovery of improper payments associated with durable medical equipment ("DME") claims, it is therefore allowing states to pay their Medicaid RACs a contingency fee of up to 17.5% for recovery of improper payments associated with DME claims.

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