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Meade Roach & Annulis assists health care providers with a full range of recovery audit contractor (RAC) support services.  The new RAC process is poised to be a time-consuming and resource-heavy enterprise for providers.  With their financial incentives to retain a portion of the Medicare recoveries they find, the RACs have developed sophisticated and aggressive positions on what constitutes an overpayment.  Providers should be prepared to defend themselves fully against over-reaching from the RACs.  There are many ways to do that, one is being ready for a timely response, another being parallel reviews to be ready to put resources into challenging negative determinations.  The appeals process for RAC determinations also affords providers opportunities to challenge errors by the RAC.

We understand that outsourcing the RAC response process, including appeals, will be costly to providers and our services are designed to assist providers in developing an in-house infrastructure to manage RAC responses and appeals.  The RAC process will need to become a permanent feature of a provider compliance and management efforts and there is no need for permanent high-cost outsourcing.  We assist clients in developing and training staff to manage RAC responses internally.  There may be a period of time in which outsourcing is needed and extra resources are required to navigate the RAC process, but our goal in an engagement is ultimately to turn the process back over to the client as quickly as possible.

Through our affiliate consulting firm, Aegis Compliance & Ethics Center, our attorneys have developed educational tools, workshops and readiness retreats, template forms and other guidance material to assist clients in the RAC process.  Everyone is in this together and like all new regulatory processes, everyone will be learning RAC interpretations at the same time, so we seek to serve as a clearinghouse of information sharing.  In that regard, Aegis offers a subscription service that allows clients to keep up on developments around the country and for us to communicate effective strategies that providers are learning and utilizing in response to RAC audits. Click here to visit the Aegis website for more information.