The Medicaid Recovery Audit Contractor program is set to go into effect in less than a month, and is expected to save taxpayers more than $2 billion by 2017. Becker's Hospital Review recently identified the biggest ways the program will affect healthcare facilities in 2012.
Although the RAC program is national, audit rules will vary between states because Medicare is a joint venture between governments at the federal and state level. Hospitals will be required to be familiar with the rules pertaining to their area, and healthcare facilities that span several states should be mindful of the fact that specific rules may vary.
"The best way to prepare is to make sure processes are in place around responding to requests, look at the rules and do a 'fire drill,'" advised John Brooke, general manager of healthcare for Compliance 360, as quoted by the news source.
The program for Medicaid recovery audits is based on the Medicare equivalent. According to a recently released report from the Centers for Medicare & Medicaid Services, Medicare RACs corrected more than $939 million worth of payments in 2011 – a nearly tenfold increase over figures from last fiscal year, FierceHealthcare reports.