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RAC Permanent Program

Protest of RAC Awards and Automatic Stay: The Centers for Medicare & Medicaid Services (CMS) is required to impose an automatic stay in the contract work of the four Recovery Audit Contractors (RAC) program. This action is the result of protests filed by two unsuccessful bidders for the RAC program with the Government Accountability Office (GAO).

An automatic stay will stop work for all four RAC regional awards until a determination is made by GAO, as required under provisions of the Competition and Contracting Act of 1984 (CICA).

Under the CICA, GAO has 100 days to issue its decision, which means a decision would be due for these protests in early February. The four RAC contracts - and any work under those contracts - are on hold pending the outcomes of the protests.

RAC Permanent Program:  Section 302 of the Tax Relief and Health Care Act of 2006 makes the RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than 2010.  See below for a link to the text of this legislation.  This web page describes CMS' strategy for expanding from a 3-state demonstration RAC Program to a 50-state permanent RAC Program.

Implementation Strategy:  By 2010, CMS plans to have 4 RACs in place.  Each RAC will be responsible for identifying overpayment and underpayments in approximately ΒΌ of the country. The new RAC jurisdictions match the DME MAC jurisdictions.  See below for a link to the RAC Jurisdiction Map.

The RAC demonstration program has proven to be successful in returning dollars to the Medicare Trust Funds and identifying monies that need to be returned to providers. It has provided CMS with a new mechanism for detecting improper payments made in the past, and has also given CMS a valuable new tool for preventing future payments. 

  • Step 1 - Expand the Current RACs:  In the Spring of 2007, CMS added one state to each of the current 3 RAC jurisdictions.   
  • Step 2 - Full and Open Competition for 4 RAC Jurisdictions: In the Spring of 2007, CMS began the process to procure 4 RAC contractors through a full and open competition.  On March 16, 2007 CMS released a Request for Information (RFI) which contained a draft statement of work. On August 16, 2007 CMS released a pre-solicitation notice which contained a statement of work. On October 19, 2007, CMS released a Request for Proposal (RFP) which opened a Question and Answer period. On November 7, 2007, CMS posted a revised Statement of Work. Answers to the questions were posted on November 19, 2007. See below for link.

On October 6, 2008, CMS announced the names of the new national RACs. The new RACs are:

  • Diversified Collection Services, Inc. of Livermore, California, in Region A, initially working in Maine, New Hampshire, Vermont,  Massachusetts, Rhode Island and New York. 
  • CGI Technologies and Solutions, Inc. of Fairfax, Virginia, in Region B, initially working in Michigan, Indiana and Minnesota.
  • Connolly Consulting Associates, Inc. of Wilton, Connecticut, in Region C, initially working in South Carolina, Florida, Colorado and New Mexico.
  • HealthDataInsights, Inc. of Las Vegas, Nevada, in Region D, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona.

Additional states will be added to each RAC region in 2009.


Downloads
Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb]

Map of Future RAC Jurisdictions [pdf, 154kb]

RAC Expansion Schedule [pdf, 61.0kb]

Related Links Inside CMS
2008 Press Release Announcing New National RACs

2008 RAC Fact Sheet

Frequently Asked Questions

Get Recovery Audit Contractor (RAC) e-mail updates
Related Links Outside CMSExternal Linking Policy
Final RFP (and Statement of Work) for 4 new permanent RACs

 

Page Last Modified: 01/06/2009 8:06:11 AM
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