It is important for all anesthesia practices to be familiar with the RAC program.

 

The Recovery Audit Program was mandated in 2003. The intention was to find and correct improper Medicare payments paid to health care providers participating in the fee-for service Medicare program.  The goal of the RAC programs is to identify both overpayments and underpayments to physicians.

The National RAC program is an outgrowth of a successful demonstration program.  Consequently, the Tax Relief and Health Care Act of 2006 made the RAC program permanent and required it be expanded to all 50 states.

 

The RAC program uses auditors that focus on areas where billings for Medicare services are higher than other areas.  RACs are entitled to keep a contingency fee of the money they return and RACs can look back at records for the past three years.

 

The RAC program is here to stay and any group that bills Medicare should be aware of their presence.