Which contractor is responsible for conducting Recovery Audit activities?

Which contractor is responsible for conducting Recovery Audit activities?

• A. Zone Program Integrity Contractor (ZPIC)
• B. Recovery Audit Contractor (RAC)
• C. Unified Program Integrity Contractor (UPIC)
• D. Comprehensive Error Rate Testing (CERT)

Answer: (B)

Recovery Audit activities are conducted by Recovery Audit Contractors. These contractors are specifically contracted by CMS to perform Recovery Audits of Medicare claims, using data analysis to detect improper payments and to recover funds. They operate across regions and coordinate with Medicare Administrative Contractors to recoup overpayments and to help improve payment accuracy. The other contractor types have different roles: Zone Program Integrity Contractors focus on fraud, waste, and abuse and overall program integrity; Unified Program Integrity Contractors handle program integrity across CMS programs; and Comprehensive Error Rate Testing teams estimate the national improper payment rate and support payment accuracy initiatives.

Recovery Audit activities are conducted by Recovery Audit Contractors. These contractors are specifically contracted by CMS to perform Recovery Audits of Medicare claims, using data analysis to detect improper payments and to recover funds. They operate across regions and coordinate with Medicare Administrative Contractors to recoup overpayments and to help improve payment accuracy. The other contractor types have different roles: Zone Program Integrity Contractors focus on fraud, waste, and abuse and overall program integrity; Unified Program Integrity Contractors handle program integrity across CMS programs; and Comprehensive Error Rate Testing teams estimate the national improper payment rate and support payment accuracy initiatives.