Medicaid RACs

Medicaid RACs (Recovery Audit Contractors) are specialized organizations hired by state Medicaid programs to review claims and ensure funding is correctly allocated. Their goal is to identify and recover mistakenly paid funds, whether from billing errors or improper claims. RACs analyze medical billing data, determine if services were appropriate and properly documented, and work with providers to correct issues. This process helps Medicaid maintain financial integrity and ensures taxpayer dollars are used properly to support eligible individuals’ healthcare needs.