CMS often receives referrals of potential improper payments from the MACs, UPICs, and Federal investigative agencies (e.g., OIG, DOJ). At CMS discretion, CMS may require the RAC to review claims, based on these referrals. These CMS-Required RAC reviews are conducted outside of the established ADR limits.
News and Alerts Updates
Archive for all Region 1 and Region 5 Updates
April 8, 2019
January 8, 2018
Effective 1/31/18, all customer support services will no longer be available for Region A inquiries. The new RAC contracts for Region 1 and Region 5 will be unable to service the outgoing RAC contracts that end January 2018. Please redirect Region A inquiries to your respective Medicare Administrative Contractor (MAC) or Centers for Medicare and Medicaid Services (CMS).
December 22, 2017
Performant will be closed for the Holidays, December 25 and 26, 2017. We will return all messages December 27 upon our return. We will be closed to observe New Year’s day, Monday, January 1, 2018. From all of us to all of you have a safe and happy holiday season.
September 14, 2017
Effective 09/10/2017, The Centers for Medicare and Medicaid Services has issued a contractual guidance to the RACs regarding Hurricane Irma and its impact to the State of Florida (FL), the territory of the United States Virgin Islands, or the Commonwealth of Puerto Rico. The RAC’s will not send medical review additional documentation requests (ADR’s) to any providers in these affected areas for a period of 60 days starting on September 10, 2017. In addition, the RAC’s will not deny claims for providers which have been designated by the Federal Emergency Management Agency (FEMA) as eligible for direct federal assistance for a total of 60 days. Information by state and county is available on the FEMA Website at: Regarding Florida, per FEMA’s website, https://www.fema.gov/disasters.
September 5, 2017
Effective 09/01/2017, The Centers for Medicare and Medicaid Services has issued a contractual guidance to the RACs regarding Hurricane Harvey and its impact to the States of Texas and Louisiana. Effective immediately, the RAC’s will not send medical review additional documentation requests (ADR’s) to any providers in Texas (TX) and Louisiana (LA) for a period of 30 days starting on September 1, 2017. In addition, the RAC’s will not send ADRs or deny claims for providers in the zip codes which have been designated by the Federal Emergency Management Agency (FEMA) as eligible for direct federal assistance, for an additional 30 days (for a total of 60 days). This applies only to counties with FEMA major disaster declarations eligible for direct federal assistance as of September 1, 2017 (not counties with emergency designations or other declarations). Information by state and county is available on the FEMA Website at: https://www.fema.gov/disasters.
Specific Impacted Counties in Texas include: Aransas, Austin, Bastrop, Bee, Brazoria, Calhoun, Chambers, Colorado, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Hardin, Harris, Jackson, Jasper, Jefferson, Karnes, Kleberg, Lavaca, Lee, Liberty, Matagorda, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Sabine, San Jacinto, San Patricio, Tyler, Victoria, Walker, Waller and Wharton. Please see https://www.fema.gov/disaster/4332 for additional information.
Regarding Louisiana, per FEMA’s website, https://www.fema.gov/archive/disaster/3382 , as of September 1, 2017, no counties in Louisiana were designated by FEMA as eligible for direct federal assistance.