he new Requests for Proposal (RFPs) have been released by CMS for the next round of Recovery Auditor Contractors (RACs). As we learned earlier this year, the national RAC contract (originally awarded to Connolly) was retracted after bid protests were filed by the incumbent jurisdiction A RAC (Performant Recovery). During the protests, CMS extended the existing recovery audit contracts in each jurisdiction to continue claim development while they deliberated next steps.
The agency then announced those next steps on November 6th, establishing October 31st as the last day that existing RACs could send Additional Documentation Requests (ADRs) under their current contracts (to expire December 31st). That stipulation was only in place until the incumbent contractors signed the proposed contract modifications to extend review work through July 31, 2016.
A series of follow up notices were then posted to the RAC webpage, the most recent of which states that all Recovery Audit Contractors may now resume auditing activity as of November 16th. The newly signed contract extensions will allow CMS time to procure new contracts for a National DMEPOS, Home Health, and Hospice Recovery Auditor. Note that the RACs will be eligible to begin new reviews under these extensions.
The agency then announced those next steps on November 6th, establishing October 31st as the last day that existing RACs could send Additional Documentation Requests (ADRs) under their current contracts (to expire December 31st). That stipulation was only in place until the incumbent contractors signed the proposed contract modifications to extend review work through July 31, 2016.
A series of follow up notices were then posted to the RAC webpage, the most recent of which states that all Recovery Audit Contractors may now resume auditing activity as of November 16th. The newly signed contract extensions will allow CMS time to procure new contracts for a National DMEPOS, Home Health, and Hospice Recovery Auditor. Note that the RACs will be eligible to begin new reviews under these extensions.
CMS also posted an updated document which statuses each of the contract enhancements originally published by the agency in December 2014. Many of the enhancements have already been instituted, such as the establishment of a Provider Relations Coordinator. Other enhancements, such as the ADR limits based on provider compliance, are scheduled to begin in the future. The most controversial enhancement, the change to the RAC payment schedule (which prompted the bid protests by Performant Recovery), does not currently have an effective date but remains on the schedule as TBD (to be determined). See the full list of enhancements and their status here.
RSS Feed