N.C. Medicaid Recovery Audit Contractors (RAC)

Under the Medicaid RAC program, states must enter into contracts consistent with State law with one or more eligible Medicaid RACs to perform post-payment audits in order to identify Medicaid payments that may have been underpaid or overpaid. Effective October 1, 2012, DMA has contracted with HMS to become the second RAC vendor. HMS will perform post-pay audits on laboratory and x-ray claims. DMA will be working with HMS to establish a schedule for RAC audits and will publish notice in the Medicaid Bulletin regarding the service types selected for audit prior to the audit implementation period.