medicaid · Centers for Medicare and Medicaid Services · Rule · Published 2011-09-16 · Effective 2012-01-01 · 76 FR 57808
Document
Document number
2011-23695
Federal Register citation
76 FR 57808
CFR reference
42 CFR 455
Type
Rule
Action
Final rule.
Category
medicaid
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2011-09-16
Effective date
2012-01-01
HHS docket
CMS-6034-F
Abstract
This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.