subject: Be aware of these RAC fast facts [print this page] Be aware of these RAC fast facts Be aware of these RAC fast facts
Be aware of these RAC fast facts
Recovery Audit Contractors (RACs) are just another tool in the government's armory to gather inappropriate payments.
You have got so many compliance acronyms flying at you each day that you may not be able to discriminate your RAC from the OIG. Here are some quick facts about RACs to help you stay better informed:
RAC detect and correct past improper payments so that CMS and the MACs can prevent such problems in the times to come.
RACs are hired as contractors by the government and they can gather contingency fees, which means, that they get a percentage of the amount that they recover from providers who were not paid properly. The maximum RAC lookback period is three years, and they cannot review claims paid prior to October 1, 2007.
Between year 2005 and year 2008, RACs involved in the original demonstration project recovered over $1.03 billion in Medicare improper payments, however referred only two cases of potential fraud to Centers for Medicare and Medicaid Services (CMS), according to a February OIG report on the topic, which noted that "as RACs do not get their contingency fees for cases they refer that are determined to be fraud, there may be a disincentive for RACs to refer potential cases of fraud.
Contrary to RACs, the OIG is a government entity. Although the OIG also carries out reviews and audits and seeks improper payments, the OIG doesn't gather contingency fees. You can visit www.cms.gov/rac for more on RAC program. You can even sign up for newsletters and keep yourself up to date on all changes.
