Medicare Recovery Audit Contractors (RAC)

Medicare The Medicare Recovery Audit Contractor (RAC) program is authorized by Congress to identify improper Medicare payments – both overpayments and underpayments. Following a three-year demonstration project, the RAC program is now operating in every state in the nation. RACs are paid on a contingency fee basis, receiving a percentage of the improper payments they identify and collect. The contractor for Kansas, which is Region D, is HealthDataInsights. The CMS Project Officer for HDI is Brian Elza. Brian can be reached by at (866) 590-5598 (Part A) or (866) 376-2319 (Part B).

KHA wants to ensure Kansas providers are as well informed and prepared to respond to the implementation of the RAC program as possible. Below you will find articles and information regarding the RAC program. Questions regarding RAC can be addressed to Fred Lucky or Tish Hollingsworth.

Informational Links

RAC Downloads

Below are documents that will help you to understand the current status of the RAC program and to prepare for the RAC reviews.

 



 
For more information, contact Melissa Hungerford or Susan Cunningham at (785) 233-7436.

 
 
For more information, contact Amy Fluke at (785) 233-7436.

 
 
For more information, contact the KHA Education Department at (785) 233-7436 or ccarney@kha-net.org.

 
 
Compensation Models

 
 
For more information, Lorri Dean or Steve Poage at (785) 233-7436.

 
 
RAC
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Medicare Recovery Audit Contractors (RAC)

Medicare The Medicare Recovery Audit Contractor (RAC) program is authorized by Congress to identify improper Medicare payments – both overpayments and underpayments. Following a three-year demonstration project, the RAC program is now operating in every state in the nation. RACs are paid on a contingency fee basis, receiving a percentage of the improper payments they identify and collect. The contractor for Kansas, which is Region D, is HealthDataInsights. The CMS Project Officer for HDI is Brian Elza. Brian can be reached by at (866) 590-5598 (Part A) or (866) 376-2319 (Part B).

KHA wants to ensure Kansas providers are as well informed and prepared to respond to the implementation of the RAC program as possible. Below you will find articles and information regarding the RAC program. Questions regarding RAC can be addressed to Fred Lucky or Tish Hollingsworth.

Informational Links

RAC Downloads

Below are documents that will help you to understand the current status of the RAC program and to prepare for the RAC reviews.

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AHA RACTrac Flyer - March 2010
AHA RACTrac Flyer 3-1-10.pdf
(367,258 bytes)
Posted on Wednesday, March 03, 2010 (CST)
For more information, contact Tish Hollingsworth at (785) 233-7436 or thollingsworth@kha-net.org.
  
AHA RAC Update - March 2010
AHA RAC Update March 2010.pdf
(87,448 bytes)
Posted on Wednesday, March 03, 2010 (CST)
Contact Tish Hollingsworth at (785) 233-7436 or thollingsworth@kha-net.org if you have questions.
  
CMS DRG Validation ADR Limit (Jan. 2010)
CMS DRG Validation ADR Limit 1-10.pdf
(53,699 bytes)
Posted on Monday, February 22, 2010 (CST)
For more information, contact Tish Hollingsworth or Fred Lucky at (785) 233-7436.
  
Humana DRG Appeals Process (Feb., 2010)
Humana DRG Appeals Process 2-10.pdf
(18,967 bytes)
Posted on Monday, February 22, 2010 (CST)
If you have questions regarding this issue, contact Fred Lucky or Tish Hollingsworth at (785) 233-7436
  
CMS Payment Dispute Resolution (Jan. 4, 2010)
CMS Pmt Dispute Resolution 1-4-10.pdf
(82,452 bytes)
Posted on Monday, February 22, 2010 (CST)
For more information regarding this topic, contact Tish Hollingsworth or Fred Lucky at (785) 233-7436.
  
Medicare Appeals Process Brochure (Feb. 2010)
Medicare Appeals Process Brochure 2-10.pdf
(1,146,794 bytes)
Posted on Monday, February 22, 2010 (CST)
If you have questions regarding this information, contact Tish Hollingsworth or Fred Lucky at (785) 233-7436.
  
Sample HDI ADR Letter 2-2-10
Sample HDI ADR Letter 2-2-10.pdf
(56,570 bytes)
Posted on Thursday, February 04, 2010 (CST)
If you have questions regarding this document, contact Tish Hollingsworth at (785) 233-7436. More information regarding this issue may also be found in the Feb. 5 issue of Current Report.
  
AHA's RAC Update - January 11, 2010
AHA RAC Update 1-11-10.pdf
(92,418 bytes)
Posted on Wednesday, January 13, 2010 (CST)
If you have questions regarding this document, contact Tish Hollingsworth or Fred Lucky at (785) 233-7436.
  
Current RAC PowerPoint Slides as of July 17, 2009
Current RAC PP slides as of 7-17-09.pdf
(1,356,189 bytes)
Posted on Thursday, October 22, 2009 (CST)
Current RAC PowerPoint Slides as of July 17, 2009
  
RAC Presentation - Aug. 6, 2009
RAC Presentation 080609.pdf
(325,621 bytes)
Posted on Thursday, October 22, 2009 (CST)
RAC Presentation - Aug. 6, 2009
  
MLN Matters Newsletter
MM6183.pdf
(120,736 bytes)
Posted on Thursday, October 22, 2009 (CST)
MM6183
  
RAC Fax Back Form
RAC Fax Back Form.doc
(36,353 bytes)
Posted on Friday, October 16, 2009 (CST)
RAC Fax Back Form
  
HealthDataInsights Letter to Hospitals - August 2009
Letter to Hospitals from HDI 8-09.jpg
(181,302 bytes)
Posted on Wednesday, August 26, 2009 (CST)
HealthDataInsights Letter to Hospitals - August 2009
  
CMS Handouts - August RAC Informational Meeting
CMS Handouts RAC Info Meetings.pdf
(2,500,243 bytes)
Posted on Thursday, August 13, 2009 (CST)
CMS Handouts from August 2009 RAC Informational Meeting.
  
HDI Handouts - August RAC Informational Meeting
HDI Handouts RAC Info Meetings.pdf
(5,202,585 bytes)
Posted on Thursday, August 13, 2009 (CST)
HDI Handouts from RAC August 2009 informational meeting.
  
RAC Statement of Work - Amendment No. 1
RAC Statement of Work.pdf
(205,836 bytes)
Posted on Thursday, July 16, 2009 (CST)
RAC Statement of Work - Amendment No. 1 - Nov. 7, 2007
  
CMS RAC Medical Record Request Limits
CMS RAC Medical Record Request Limits 6-09.pdf
(21,659 bytes)
Posted on Monday, July 06, 2009 (CST)
Questions regarding this document may be directed to Tish Hollingsworth at KHA at (785) 233-7436 or thollingsworth@kha-net.org.
  
CMS RAC Review Phase-In Strategy
CMS RAC Review Strategy 6-24-09.pdf
(29,877 bytes)
Posted on Monday, July 06, 2009 (CST)
For more information regarding RAC, contact Tish Hollingsworth at (785) 233-7436.
  
AHA Advisory - RAC Permanent Program Basics
AHA Advisory - RAC Permanent Program Basics 4-20-09.pdf
(344,512 bytes)
Posted on Thursday, May 21, 2009 (CST)
RAC Permanent Program Basics - April 20, 2009
  
AHA Advisory/Bulletin - Coding and Documentation
AHA Reg Advisory Coding and Docum 7-16-08.pdf
(189,077 bytes)
Posted on Thursday, May 21, 2009 (CST)
Coding and Documentation - July 16, 2008
  
AHA Advisory/Bulletin - New RAC
AHA Bulletin - New RAC 7-11-08.pdf
(26,899 bytes)
Posted on Thursday, May 21, 2009 (CST)
New RAC - July 11, 2008
  
CMS Update - Open Door Forum
CMS Open Door Forum on RAC 4-8-09.pdf
(92,980 bytes)
Posted on Thursday, May 21, 2009 (CST)
Open Door Forum - April 8, 2009
  
CMS Update - Schedule Rollout
CMS Rollout State Schedule 3-13-09.pdf
(42,102 bytes)
Posted on Thursday, May 21, 2009 (CST)
Schedule Rollout - March 13, 2009
  
CMS Update - Evaluation of Demonstration
RAC Update to Eval of Demo 1-09.pdf
(63,843 bytes)
Posted on Thursday, May 21, 2009 (CST)
Evaluation of Demonstration - January 2009
  
CMS Update - Evaluation of Demonstration
RAC Update to Eval of Demo 9-08.pdf
(72,750 bytes)
Posted on Thursday, May 21, 2009 (CST)
Evaluation of Demonstration - September 2008
  
CMS Update - Evaluation of Demonstration
RAC Update to Eval of Demo 7-08.pdf
(734,360 bytes)
Posted on Thursday, May 21, 2009 (CST)
Evaluation of Demonstration - July 2008
  
CMS Update - News Release on Demonstration
CMS News Relase on Demo 7-11-08.pdf
(59,579 bytes)
Posted on Thursday, May 21, 2009 (CST)
CMS News Release on Demonstration - July 11, 2008
  
Appeals - AHA Regulatory Advisory - March 2009
AHA Medicare Appeals Regulatory Advisory 3-27-09.pdf
(425,106 bytes)
Posted on Thursday, May 21, 2009 (CST)
AHA Regulatory Advisory - - March 2009
  
RACTrac - AHA Final Brochure
PCS - AHA RACTrac Brochure FINAL Updated May 18-09.pdf
(415,883 bytes)
Posted on Thursday, May 21, 2009 (CST)
AHA RACTrac Brochure - Final - Updated May 18, 2009
  
RACTrac - AHA Advisory
AHA RAC Trac Advisory 4-24-09.pdf
(481,933 bytes)
Posted on Thursday, May 21, 2009 (CST)
AHA RACTrac Advisory - April 24, 2009
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