Recovery Audit Contractor (RAC) Program

Hospitals are focused on caring for patients. However, hospitals are facing more audits of payment claims, including by recovery audit contractors (RACs), which subject hospitals to additional administrative burden and costly payment denials.

RACs have audited provider claims for the Medicare program nationwide since 2010. The AHA continues to work with government stakeholders to improve the RAC program and prevent abuses that preclude hospitals from receiving payment for necessary medical care. The AHA also provides education to members to help prevent payment denials and navigate the Medicare appeals process in the event of an adverse RAC payment determination.

RAC-related news, resources and educational materials can be found below.  To be kept up to date on the latest RAC news, AHA members can join AHA's RAC News Group.


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