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HHS/CMS RIN: 0938-AQ19 Publication ID: Fall 2010 
Title: ●Use of Recovery Audit Contractors (CMS-6034-P) 
Abstract: This proposed rule would provide guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs), and the payment methodology for State payments to Medicaid RACs in accordance with section 6411 of the Affordable Care Act. In addition, this rule proposes requirements for States to assure that adequate appeals processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Finally, the rule proposes that States and Medicaid RACs coordinate efforts with existing contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies. 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: State, local, or tribal governments; Private Sector 
CFR Citation: Not Yet Determined (To search for a specific CFR, visit the Code of Federal Regulations.
Legal Authority: PL 111-148, sec 6411; PL 111-152 
Legal Deadline:
Action Source Description Date
Final  Statutory    12/31/2010 
Timetable:
Action Date FR Cite
NPRM  12/00/2010   
Regulatory Flexibility Analysis Required: No  Government Levels Affected: State 
Small Entities Affected: Businesses, Governmental Jurisdictions  Federalism: Yes 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Joanne Davis
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Mail Stop B2-15-24, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-5127
Fax:410 786-0711
Email: joanne.davis@cms.hhs.gov

 
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