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Even though RACs are on hold for the moment, more than a dozen states are in the CMS crosshairs when the program resumes sometime in February of next year.


But don’t expect to see RAC auditors showing up and requesting to see medical records. RAC activity for first wave states is what CMS is calling ‘provider outreach and education,’ a way of saying that it will  prepare information for Medicare providers as to what to expect when the program is phased in nationally.


Essentially, CMS will pick up where it left off on November 4, 2008, when the program was put on automatic stay because of a contractor dispute.


When the program does resume, RACs are expected to hold town hall type meetings in each state with Medicare providers and the CMS staff and RAC representatives.


CMS said it would also continue to work “closely with national and state medical, hospital and nursing home associations to strengthen relationships to be more proactive and anticipate the needs and concerns of health care providers.”


Those associations in the first wave of states include the following:


Region A

New Hampshire Hospital Association

Greater New York Hospital Association

Healthcare Association of New York State

Maine Hospital Association

Massachusetts Hospital Association

Vermont Hospital Association

Rhode Island Hospital Association


Region B

Indiana Hospital Association

Michigan Health Association

Minnesota Hospital Association


Region C

Oncology State Society Network, Albuquerque, New Mexico

New Mexico Hospital

South Carolina Hospital Association

Rehab Service Palmetto Health Baptist, South Carolina

Colorado Hospital Association

South Florida Hospital Association

Florida Hospital Association


Region D

Montana Hospital Association

Wyoming Hospital Association

Utah Hospital Association

North Dakota Hospital Association

South Dakota Hospital Association

Arizona Hospital Association


Upon completion of RAC provider education, CMS says that some healthcare organizations in first wave states may receive either requests for medical records or a letter requesting that an overpayment be repaid for their claims that were submitted to and paid for by Medicare.


Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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