US · guidance
CMS Pub. 100-08, ch. 9, § 9.1
Medicare FFS Recovery Audit Program
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.
History
(Rev. 921, Issued: 11-06-19 Effective: 11-04- 19, Implementation: 11-04-19)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5910065ecb4caa44bfc0bb4bb2b93ba108c16bcf43431703936092265f93d3c7
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