Payer Power

The 2010 Affordable Care Act (ACA) required states to implement Medicaid Recovery Audit Contractor (RAC) programs for the purpose of identifying and correcting inappropriate Medicaid payments. The Centers for Medicare & Medicaid Services oversees the RAC program as a whole and provides guidance, but states have the flexibility to select their own RAC contractor, define their audit scope, and design a RAC program that meets their specific needs.  The final episode of HMS’s podcast mini-series, “Federal Audits: What States Need to Know,” discusses some of the challenges states have faced during their Medicaid RAC implementations and offers suggestions for ensuring future success.