Of the former DME RAC Contract holders, notably absent is the JB RAC contractor CGI. As you may recall, CGI filed a formal protest in 2014 based on CMS’s change to the contingency fee timeline that would delay payments to the RACs on recovered funds until after the resolution of a second level of appeal. CMS has moved forward with this condition in their contract awards, and CGI opted not to participate in the bidding process.
- Region 1 – Performant Recovery, Inc. (the former JA RAC)
- Region 2 – Cotiviti, LLC (previously Connolly the former JC RAC)
- Region 3 – Cotiviti, LLC (previously Connolly the former JC RAC)
- Region 4 – HMS Federal Solutions (acquired Health Data Insights the former JD RAC)
- Region 5 – Performant Recovery, Inc. (the former JA RAC)
Several new program enhancements should garner more accurate audit results and curb unnecessary appeal activity in this round of contracting. Beyond the delayed contingency payment terms, the RAC Program Enhancements document outlines several additional program changes. We will delve deeper into the program enhancements that will impact DME providers in our next edition of our signature publication Vista Notes. To subscribe to this publication and secure 6 private webinars with Andrea Stark over the course of a year, please click here for subscription details.