Recovery Audit Contractor (RAC)

AHA members have expressed significant concerns about Cotiviti’s audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed. Therefore, we urge the VA to issue proposed rulemaking not only to allow…
This page contains materials related to AHA’s current and active policy-related litigation.
AHA urges the Centers for Medicare & Medicaid Services to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency.
In a blog post today, Centers for Medicare & Medicaid Services Administrator Seema Verma highlights recent progress in reducing provider complaints related to the Medicare Recovery Audit Contractor program and associated backlog of appeals.
Memorandum Opinion This case is now before the Court for a third time, following a second remand from the D.C. Circuit. Plaintiffs here are the American Hospital Association and three other regional hospitals and health-care systems. Fed up by the delays in the administrative-appeals process for…
Appeals court sends order to eliminate backlog of Medicare appeals back to trial court (August 11, 2017) Government's reply brief in the ALJ Delay Mandamus Appeal (April 6, 2017)
AHA, Hospitals' lawsuit to require HHS to meet deadlines for deciding appeals.   Reply Memorandum in Support of AHA and Hospitals' Cross-Motion for Summary Judgment. Plaintiffs' summary-judgment motion granted.
AHA Audit Education SeriesPrior RAC Educational EventsFall Audit Education Series Webinars (October - November 2012): Click here to view the video recordings
RACs FOR REGION A Performant Recovery, Inc. of Livermore, California, in Region A, initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and New York PRG-Schultz USA, Inc. will act as a subcontractor to Diversified Collection Services, Inc.