In June 2025, Colorado passed a new law that makes significant changes to the state’s Medicaid Recovery Audit Contractor (RAC) program. Colorado has one of the most aggressive RAC programs in the ...

With the Jan. 9 deadline for submitting comments on the proposed rules for the Medicaid Recovery Audit Contractor program drawing near, the AHA and other hospital organizations have submitted a ...

CMS has made a number of changes to the Recovery Audit Contractor program after evaluating provider concerns raised about the program. Here are 10 things to know about the changes to the RAC program.

4. Exclude medical necessity reviews. CMS should exclude medical necessity reviews from the Medicaid RAC program. In the Medicare demonstration, such reviews “led to aggressive and inappropriate ...

Throughout the demonstration, the RAC program has cost only 20 cents for each dollar collected. Of the overpayments, 85 percent were collected from inpatient hospital providers, and the other ...

Thank you for everything you do in the pursuit of greater transparency and accountability within the federal government. Making Washington work for families across the nation is a top priority, and we ...

Hold on to your stethoscopes, the Senate Healthcare Reform Bill is expanding the RAC program. Specifically, Section 6411 of the Patient Protection and Affordable Care Act (H.R.3590, p. 1777–1783) ...

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