Recovery Audit Program
The goal of the Recovery Audit program is to identify and reduce improper payments made on claims for services provided to Medicare beneficiaries. All providers, including home health and hospice providers, may be subject to claims review by a RAC.
Recovery auditors (formerly known as Recovery Audit Contractors or RACs) are divided into jurisdictions, and are separate from the contract that CGS has to processing Medicare claims. Refer to the Medicare Fee-for-Service RAC Regions map and the CMS Medicare Fee for Service Recovery Audit Program Web page for additional information.
For contact information, refer to the "Medicare Fee For Service RAC Contact Information" on the CMS website. Each recovery auditor will publish the issues they are selecting. All issues for review by the recovery auditor are approved by CMS, and posted to the Recovery Auditors websites prior to the review being conducted.
Additional Resources
- "CMS Recovery Audit Program" Web page
- "Contractor Entities At A Glance: Who May Contact You About Specific CMS Activities" SE1123
- "Contractor Entities At A Glance: Who May Contact You About Specific CMS Activities" fact sheet
- CMS "Program Integrity Manual" (CMS Pub. 100-08), Ch. 4, §4.33
- "CMS Recovery Audit Program" Web page
- CGS Recorded Webinar: 07.23.2020, A Discussion with Performant – Our Recovery Audit Contractor
Updated: 05.21.21