Medicare Program Integrity Manual (Pub. 100-08), Ch. 9 § 9.14
Receivables Initiated by the RAC as Independent Audit
9.14 - Receivables Initiated by the RAC as Independent Audit
Accessible Information
(Rev. 921, Issued: 11-06-19 Effective: 11-04- 19, Implementation: 11-04-19)
As stated in the MFMM, Chapter 7, Section 20.1, CMS requires its contractors to
perform risk assessments on an annual basis. If an independent auditor requests the MAC
to provide information on a RAC-initiated improper payment, the MAC shall request the
documentation from the RAC and submit it to the auditor as requested. This process shall
be documented in the JOAs. Situations where the RAC does not provide documentation
as requested should be sent to the CMS COR, as soon as possible.