Automated Tracking and Reporting of Recovery Audit-Associated Reopenings and Appeals

Changes to Recovery Audit Contractor (“RAC”) tracking and reporting of RAC-associated reopenings and appeals data were recently implemented. Specifically, CMS Transmittal 1093, dated May 23, 2012, deleted Business Requirement 7604.2.4, required under Change Request (“CR”) 7469, which mandated specific data transfer protocols related to the information. The Business Requirement was deleted due to RAC-data warehouse limitations. See http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1093OTN.pdf
and https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1050OTN-.pdf

CMS currently tracks reopenings and appeals of adjustments by RACs through monthly contractor-supplies spreadsheets. The Transmittal referenced above directs implementation of automated tracking/reporting solutions.

For more information regarding issues surrounding RACs, please contact Abby Pendleton, Esq. or Jessica Gustafson, Esq. at 248-996-8510 or visit The HLP website.