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Expansion of the Recovery Audit Contractor (RAC) Program
Section 6411 of the Affordable Care Act


Read the statutory language applicable to this section

Brief analysis

Federal regulations


Medicare Recovery Audit Contractors (RACs) are private entities with which CMS contracts to identify and collect improper payments made in Medicare’s fee-for-service program. Medicare RACs are pad on a contingency fee rate ranging between 9 and 12 percent of the amount collected.

The Affordable Care Act expanded the RAC program to Medicaid and requires the states Act to require States to establish programs by December 31, 2010, to contract with 1 or more Medicaid RACs to audit Medicaid claims and to identify underpayments and overpayments. States must fully implement their Medicaid RAC programs by April 1, 2011.


Federal Regulations

Final RAC Expansion Rules
Final rules published September 16, 2011 to implement section 6411: Expansion of the Recovery Audit Contractor Program.
Effective Date: January 1, 2012

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