Medicaid Program; Recovery Audit Contractors

Document ID: CMS-2010-0252-0077
Document Type: Rule
Agency: Centers For Medicare & Medicaid Services
Topics: Fraud, Grant Programs-Health, Health Facilities, Health Professions, Investigations, Medicaid, Reporting and Recordkeeping Requirements
Federal Register Number: 2011-23695
CFR Citation: 42 CFR Part 455
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Details Information

Abstract: This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.
Received Date: September 16 2011, at 12:00 AM Eastern Daylight Time
Start-End Page: 57808 - 57844
Page Count: 37

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