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The Recovery Audit Contractor or RAC program was created through the Medicare Modernization Act (MMA) of 2003 in order to identify, review, audit and recover improper Medicare payments that were paid to healthcare providers under fee–for-services Medicare plans. There are four RAC’s and each one is responsible for a designated region and each one has its own plan for targeting issues. The RAC program helps providers avoid submitting claims that do not comply with Medicare rules. According to the United States Department of Health and Human Services, they were required by law to make the RAC program permanent for all states by 2010. When the program was first introduced as a demonstration in 2005 it focused on the states of California, Florida and New York. During this time of demonstration the RAC program focused on improper payments made under the part A and B plans of Medicare and had recovered nearly six hundred and ninety three million dollars. Currently in the state of California, The California Medical Association (CMA) is pushing congressional members to co-sponsor The Fair Medical Audits Act of 2015. This legislation will address many issues and concerns that physicians have regarding the lack of clear, expensive, time consuming and unfair process that plagues the Medicare Recovery …show more content…
However, there will always be issues within our healthcare system and there will always be dishonest physicians. The fact that our government has this program in place can only help reduce overpayments and underpayments and will do its best to correct these issues. Nothing is one hundred percent full proof. As a medical coder it is my responsibility to ensure that claims being paid are not based on outdated fee schedules and that double payments aren’t made on the same claim. Individual review of each claim is of the utmost importance in order to avoid these issues and prevent an RAC

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