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Medicaid Payment Audit and Recovery
- This RFP had a pre-bid event.
The Contractor shall assist the State in post-payment identification, audit, and recovery of improper Medicaid payment through reviewing MMIS claims and encounters. The Contractor shall maintain up-to-date knowledge of Federal and State laws as well as policy related to the scope of improper Medicaid payment. Further, the Contractor shall assist the State with the mandate to implement the Medicaid Recovery Audit Contractor (RAC) program as required by the Patient Protection and Affordable Care Act. The Contractor shall be required to conform to federal requirements of the RAC program once issued by CMS.
