Payer Power

Medicare Recovery Audit Contractors (RACs) are tasked with identifying inappropriately paid Medicare claims and returning overpayments to the Medicare trust fund. The program has achieved nearly $5 billion in corrections since its inception in 2005, and plenty of recovery opportunities still exist. However, pushback from providers and Congress, as well as new regulations, could limit Medicare RACs’ effectiveness. Find out more about the history of the Medicare RAC program, its successes, and the political challenges it faces in the second episode of HMS’s podcast mini-series, “Federal Audits: What States Need to Know.”