CMS RAC Review Phase-in Schedule & Strategy

RAC Audits Phase-in Schedule

Published by CMS on 06/24/09

Includes:

• Earliest possible dates for reviews in yellow/green states (see map, below)
• Earliest possible dates for reviews in blue states
  

Download PDF HERE (PDF format, 1 pg, 152 KB)

CMS RAC Expansion Schedule Map (dated 02/10/09)

The RAC expansion schedule was reduced from three phases to two.

The first phase, delayed since November, 2008 due to a contractor protest, began March 1, 2009, but was further delayed by the need to provider Outreach Sessions, to acquaint providers with the RAC program.

The second, now final stage, will expand to cover all states after August 1, 2009. However, audits & records reviews cannot begin in any state before provider outreach sessions are conducted.

Download the map HERE. (PDF format, 1 pg, 90 KB)

CMS RAC Review Phase-in Strategy

Published by CMS on 06/24/09

CMS has restricted all reviews via their New Issues Review policy, whereby all issues must be proposed to CMS by each RAC before it can be officially reviewed by the RAC. Each issue must also be posted on a public webpage before a RAC can begin making records requests and/or conducting reviews of provider claims (except for small number of records requests for the purpose of creating said proposed "issues").

Also, the RACs are subject to a general schedule, providing the least complicated reviews to begin immediately, per the Phase-In Schedule above, and allowing more complicated reviews to begin only when CMS releases same. A graphic was published by CMS on June 24, 2009, providing a rough schedule of the earliest possible dates for the release of each type of audit/review.

Download the graphic HERE (PDF format, 1 pg, 152 KB)