CMS Puts Recovery Audit Program on Pause

The Centers for Medicare & Medicaid Services announced in late February that it will pause additional documentation requests by Recovery Audit Contractors (RAC) until new RAC contracts are finalized. The pause in requests began Febr. 21, the last day a recovery auditor could send postpayment additional documentation requests (ADRs).

Take note of the following important dates: 

  • Feb. 28 was the last day a Medicare administrative contractor (MAC) could send prepayment ADRs for the Recovery Auditor Prepayment Review Demonstration.
  • June 1 is the last day a recovery auditor may send improper payment files to the MACs for adjustment. 

"It is important that CMS transition down the current contracts so that the recovery auditors can complete all outstanding claim reviews and other processes by the end date of the current contracts. In addition, a pause in operations will allow CMS to continue to refine and improve the Medicare Recovery Audit Program," CMS said in an online notice. "CMS has proven it is committed to constantly improving the program and listening to feedback from providers and other stakeholders." 

CMS says it will "continue to review and refine the [Medicare Recovery Audit Program] process as necessary." 

The agency will continue to update its Recovery Audit Program website with more information on the procurement and awards as information is available. Providers should email RAC@cms.hhs.gov for additional information.  


Action, March 3, 2014

 


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