Indiana Medicaid Recovery Audit Contractor (RAC) to Begin Work

Indiana Medicaid released a Banner Page on Tuesday of this past week formally announcing the approval of Health Management Systems (HMS) as the RAC vendor for Indiana long term care facilities. They will perform a comprehensive review of Medicaid claims spanning a four year period (with the most recent 12 months from the date of the start of the review excluded).  Audits will focus on, but not be limited to, payments made for dates of service after discharge, duplicate payments, appropriateness of reporting of Medicare and third-party payments, and errors related to patient liability application or collection.

It is imperative that facility personnel recognize notices from HMS and elevate to the appropriate person in the company.  Tight timelines apply to complying with records request from the HMS.  The presentation from HMS that was provided to IHCA in June of this year and the Banner Page are available for access in the Members Only section of the IHCA website.