Even though RACs are on hold for the moment, more than a dozen states are in the CMS crosshairs when the program resumes sometime in February of next year.
But don’t expect to see RAC auditors showing up and requesting to see medical records. RAC activity for first wave states is what CMS is calling ‘provider outreach and education,’ a way of saying that it will prepare information for Medicare providers as to what to expect when the program is phased in nationally.
Essentially, CMS will pick up where it left off on November 4, 2008, when the program was put on automatic stay because of a contractor dispute.
When the program does resume, RACs are expected to hold town hall type meetings in each state with Medicare providers and the CMS staff and RAC representatives.
CMS said it would also continue to work “closely with national and state medical, hospital and nursing home associations to strengthen relationships to be more proactive and anticipate the needs and concerns of health care providers.”
Those associations in the first wave of states include the following:
New Hampshire Hospital Association
Greater New York Hospital Association
Healthcare Association of New York State
Maine Hospital Association
Massachusetts Hospital Association
Vermont Hospital Association
Rhode Island Hospital Association
Indiana Hospital Association
Michigan Health Association
Minnesota Hospital Association
Oncology State Society Network, Albuquerque, New Mexico
New Mexico Hospital
South Carolina Hospital Association
Rehab Service Palmetto Health Baptist, South Carolina
Colorado Hospital Association
South Florida Hospital Association
Florida Hospital Association
Montana Hospital Association
Wyoming Hospital Association
Utah Hospital Association
North Dakota Hospital Association
South Dakota Hospital Association
Arizona Hospital Association
Upon completion of RAC provider education, CMS says that some healthcare organizations in first wave states may receive either requests for medical records or a letter requesting that an overpayment be repaid for their claims that were submitted to and paid for by Medicare.