Medicare FFS Recovery Audit Program

9.1 – Medicare FFS Recovery Audit Program (Rev. 921, Issued: 11-06-19 Effective: 11-04- 19, Implementation: 11-04-19) Section 1893(h) of the Social Security Act (the Act) requires the Secretary of the Department of Health and Human Services (the Secretary) to utilize Recovery Audit Contractors (RACs) under the Medicare Integrity Program to identify underpayments and overpayments and recoup overpayments under the Medicare program associated with services for which payment is made under part A or B of title XVIII of the Act. The term RAC, as used in this section, refers to the Fee-For-Service (FFS) RACs. In 2009, CMS expanded the use of RACs nationwide. Information on the program can be found at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring- Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/ The RACs are responsible for identifying improper payments. The Medicare Administrative Contractors (MACs) are responsible for the adjustments of these claims.