CMS Solicits Proposals for New RAC Contracts
November 26, 2015 08:44 AM
On November 6, 2015, The Centers for Medicare & Medicaid Services (CMS) announced Requests for Proposals (RFPs) for the next round of Recovery Auditor Contracts (RACs). The next round of contracts will include five jurisdictions. Jurisdiction 5 will be responsible for nationwide reviews of home health, hospice and durable medical equipment claims.
CMS must begin to close out the current contracts so the Recovery Auditors can complete all outstanding claim reviews and other processes by December 31, 2015, the end date of the current contracts. CMS is also pursuing contract modifications to the current Recovery Auditor Contracts to allow each of the four existing Recovery Auditors to continue recovery auditing activities through July 31, 2016.
The current RACs have been working under a modified contract with CMS since February 2014 when the old contracts were to expire. Due to several award protests and a law suit filed over changes to the contingency payment schedule, the current contracts have been extended and modified several times.
The RACs are to continue active recovery auditing activities, including sending additional documentation requests (ADRs). New ADR limitsfor all providers (except physicians and suppliers) have been established and are based on the number of Medicare claims paid in the previous year. Reviews will continue to be conducted in 45 day cycles. In addition, CMS has issued RACprogram enhancementsto address concerns raised by providers since the initiation of RAC program.
The RFPs were released at the Federal Business Opportunity websitewhere the Statement of Work for each contract can be found.
Procurement estimated timelines are shown below:
Request for Proposal Released: November 6, 2015
Questions Due: November 16, 2015, by 11:00 A.M. (EST)
Questions answered: November 25, 2015, COB
Intent to Submit a Proposal December 1, 2015, COB
Proposals Due:December 18, 2015, by 11:00 A.M. (EST)