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 Officers for HDI are Brian Elza and Narcessa Chesil. 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.

RAC Program Update Webinar - July 8

As a response to the increased RAC activity in Jurisdiction 5 (Kansas, Missouri, Nebraska, and Iowa), a Webinar has been scheduled from noon to 1:30 p.m. on Thursday, July. The purpose of this Webinar is to provide updated information on the RAC program and to address several other issues that has arisen. For more information, download a copy of the registration brochure.

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 Amy Fluke at (785) 233-7436.
Topics to be discussed include: meaningful use objectives and quality requirements, incentive payments structure and processes, privacy and security, Kansas Medicaid HIT planning and Kansas health information exchange activity.
Topic: Conduct Effective Meetings and Tame Your Meeting Monsters
For more information regarding this program, contact Jennifer Findley or Christie Carney at (785) 233-7436.
KHA District Meetings provide information and discussion on issues such as health reform, health information technology and health information exchange that affect member hospitals.
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 Officers for HDI are Brian Elza and Narcessa Chesil. 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.

RAC Program Update Webinar - July 8

As a response to the increased RAC activity in Jurisdiction 5 (Kansas, Missouri, Nebraska, and Iowa), a Webinar has been scheduled from noon to 1:30 p.m. on Thursday, July. The purpose of this Webinar is to provide updated information on the RAC program and to address several other issues that has arisen. For more information, download a copy of the registration brochure.

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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FAQ Responses from the July 8, 2010 Webinar
FAQ Responses from Webinar 070810.pdf
89,259 bytes
Posted on Wednesday, August 25, 2010 (CST)
For more information, contact Tish Hollingsworth at (785) 233-7436 or thollingsworth@kha-net.org.
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
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