Approved RAC Topics

Do you have questions or concerns about the Recovery Audit Program? Please e-mail us at RAC@cms.hhs.gov. Please Do Not send Personal Health Information to this e-mail address.

Note: CMS often receives referrals of potential improper payments from the MACs, UPICs, and Federal investigative agencies (e.g., OIG, DOJ). At CMS discretion, CMS may require the RAC to review claims, based on these referrals. These CMS-Required RAC reviews are conducted outside of the established ADR limits.

Showing 31-40 of 145 entries

Issue Name Sort descending	Review Type	Provider Type	MAC Jurisdiction	Date Approved
0060 - Untimed Therapy: Excessive Units	Automated	Comprehensive Outpatient Rehabilitation Facility (CORF); Outpatient Hospital; Outpatient Rehabilitation Facility (ORF); Professional Services; Skilled Nursing Facility	All A/B MACs	2017-09-06
0061 - Nursing Facility Services: Excessive Units	Automated	Professional Services	All A/B MACs	2017-09-06
0062 - Radiology: Technical Component during Inpatient Stay	Automated	Professional Services	All A/B MACs	2017-09-06
0064 - Facility Duplicate Claims	Automated	Inpatient Hospital; Outpatient Hospital; Skilled Nursing Facility (SNF)	All A/B MACs	2017-09-06
0065 - Continuous Positive Airway Pressure Machine without an Obstructive Sleep Apnea Diagnosis	Automated	DME Physician/ DME Supplier	All DME MACs	2017-09-07
0067-Inpatient Psychiatric Facility Services: Medical Necessity and Documentation Requirements	Complex	Inpatient Hospital; Inpatient Psychiatric Facility (IPF)	All A/B MACs	2018-09-01
0069 - Respiratory Assist Devices: Medical Necessity and Documentation Requirements	Complex	DME Physician/ DME Supplier	All DME MACs	2017-12-12
0072 - Outpatient Service Overlapping or During an Inpatient Stay: Duplicate Payments	Automated	Outpatient Hospital	All A/B MACs	2017-10-05
0073 - Inpatient Rehabilitation Facility: Medical Necessity and Documentation Requirements	Complex	Inpatient Rehabilitation Facility (IRF)	All A/B MACs	2018-11-01
0074 - Drugs and Biologicals in Single-Dose Vials: Incorrect Units Billed	Complex	Outpatient Hospital; Professional Services	All A/B MACs	2017-12-21