CMS Publishes Proposed Rule for Medicaid RAC Program

On November 10, 2010, the Centers for Medicare & Medicaid Services (CMS) published proposed regulations which if promulgated as a final rule, will govern state implementation of the new Medicaid Recovery Audit Contractor (RAC) Program for identifying and recouping improper payments from providers (Proposed Rule) (75 Fed. Reg. 69,037; Nov. 10, 2010). As enacted in March of 2010, the Patient Protection and Affordable Care Act (PPACA) (Pub. L. 111-148) required each state Medicaid program to establish a program for contracting with one or more RACs by December 31, 2010. While acknowledging that states are still required to submit state plan amendments to the CMS by December 31, the Proposed Rule extends the deadline to April 1, 2011, for states’ Medicaid RAC programs to contract with RACs and to be fully implemented. Further, the Proposed Rule suggests that extensions or exceptions to this deadline may be available.

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