A Primer on RAC Appeals

March 31, 2009

The recovery audit contractor (RAC) program is intended to detect and correct improper payments in the Medicare program. After a successful three year demonstration project, implementation and national rollout of the RAC program is proceeding. Providers need to be prepared to file appeals quickly and without delay if they object to the RAC’s claim for overpayment. The timeframe providers have to object are short and if a provider has not thought through the appeals process beforehand, it may miss the opportunity to retain payments. This article provides a brief background of the RAC program, a short overview of the demonstration project results related to appeals, and a primer on the appeals process.

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McGuireWoods is ranked among the 6 largest health care law firms in the United States by the American Health Lawyers Association. For more information the RAC program, please contact the authors or other members of our Health Care industry group.