CMS to Restart RAC Reviews

CMS announced that it has initiated contract modifications with current recovery auditor contractors to allow the recovery auditors to restart some reviews.

The modifications are needed to address the continued delay in awarding new recovery auditor contracts (RACs), according to an update on the CMS website. In May, CMS announced that no additional RAC reviews would be conducted under the current contracts, and the program has been on hold since June. A new round of contracts has not yet been implemented.

The audits will “include a limited number of automated reviews and a small number of complex reviews,” as reported by the American Coalition for Healthcare Claims Integrity. The reviews will include but not be limited to prosthetics, orthotics and supplies; spinal infusions outpatient therapy services; durable medical equipment; and cosmetic procedures. They will not include short inpatient hospital stays.

CMS expects to award a new round of contracts before the end of the year.

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