Recovery Audit Contractor (RAC) Audits

RAC Review Results by Provider Type - Updated 12/31/16

RAC Review Process - Updated 6/15/15

About RAC Audits
  • Mandatory provisions of the Affordable Care Act require the Alabama Medicaid Agency to select and provide oversight for a Medicaid Recovery Audit Contractor (RAC) to perform provider audits. Change Healthcare (CH), formerly known as Goold Health Systems (GHS), was selected to be Alabama Medicaid’s Recovery Audit Contractor (RAC) effective January 1, 2013. Change Healthcare’s contract expired on December 31, 2016, and was not renewed. The Agency is in the process of procuring a new RAC vendor.

  • The RAC program is designed to improve payment accuracy by identifying under and overpayments in Medicaid. The Medicaid RAC program is a separate program from the Medicare RAC which is overseen by the Centers for Medicare and Medicaid Services.

  • Providers are reminded that the Alabama Administrative Code, the Provider Manual and their Provider Agreements require compliance with requests for medical records for Medicaid program audits.

  • Questions regarding the audits should be directed to Yulonda Morris Carter, RAC Program Manager, at (334) 242-5161 or yulonda.morris@medicaid.alabama.gov or Patricia Jones, Recipient Review Associate Director, at (334) 242-5609 or patricia.jones@medicaid.alabama.gov.