Recovery Audit Contractor (RAC) Program
Hospitals are focused on caring for patients. However, hospitals are facing more audits of payment claims, including by recovery audit contractors (RACs), which subject hospitals to additional administrative burden and costly payment denials.
RACs have audited provider claims for the Medicare program nationwide since 2010. The AHA continues to work with government stakeholders to improve the RAC program and prevent abuses that preclude hospitals from receiving payment for necessary medical care. The AHA also provides education to association members to help prevent payment denials and navigate the Medicare appeals process in the event of an adverse RAC payment determination.
RAC-related news, resources and educational materials can be found below. To be kept up to date on the latest RAC news, AHA members can join AHA's RAC News Group.
- RAC News Archive
- May 20, 2015 | AHA testifies at hearing on hospital observation stays
- May 13, 2015 | AHA urges Congress to enact RAC reforms
- May 7, 2015 | Hospital leaders urge Congress to support unique needs of rural patients
- May 5, 2015 | Boustany calls for 'smarter' regulation
- May 1, 2015 | Representatives introduce AHA-supported bill to improve RAC program
- Apr 30, 2015 | Reminder: Final day to complete RACTrac survey is May 1
- Apr 28, 2015 | Reminder: Final day to complete RACTrac survey is May 1
- Apr 24, 2015 | Final day to complete RACTrac survey is May 1
- Apr 16, 2015 | Hospitals given additional week to complete AHA RACTrac survey
- May 20, 2015 | To Aging Committee: Challenging the Status Quo: Solutions to the Hospital Observation Stay Crisis
- May 13, 2015 | AHA Statement Re: Needed Reforms to the Medicare Appeals and Audits Systems
- May 01, 2015 | New Legislation Provides Much-Needed Reform to the Medicare RAC Program
- May 01, 2015 | AHA-Supported Bill Introduced to Make Needed Changes to RACs
- Mar 31, 2015 | AHA Comments to MedPAC on RACs, Short Inpatient Stays and the 340B Program
- Feb 13, 2015 | AHA to CMS Re: Two-Midnight Policy and Potential Short Stay Payment Solutions
- Sep 25, 2014 | AHA to CMS: Be Clear about RAC Contingency Fee Under Appeals Settlement Offer
- Aug 21, 2014 | AHA again urges HHS to halt flawed and redundant OIG audits
- Jul 09, 2014 | AHA before the Senate's Special Committee on Aging: "Improving Audits..."
- Jul 08, 2014 | OMHA Announces Pilot Programs to Address Administrative Law Judge Appeals Backlog
Related RAC Resources