Recovery Audit Program
September 13th, 2024 Update: AHCCCS has put a hold on all RAC Activities at this time. AHCCCS will be notifying the provider community once a date has been identified to resume activities.
The Arizona Health Care Cost Containment System (AHCCCS) has partnered with Health Management Systems, Inc. (HMS), a Gainwell Technologies company, to conduct periodic reviews of claims paid by AHCCCS for health care services rendered to Medicaid members to ensure Arizona’s participation in the Centers for Medicare and Medicaid Services (CMS), Recovery Audit Program (which is ran by Recovery Audit Contractors [RACs] like HMS). The purpose of the RAC program is to identify and recover payments made to Medicaid providers that do not meet state and federal requirements to ensure the integrity of paid claims, including coding validation, payment accuracy, compliance with state and federal regulations, policies, and contractual requirements.
A webinar took place on August 13, 2024 and a video was recorded for anyone who was unable to attend.View Presentation
