Provider Review

• Provider Review Results by Provider Type FY18 Q1 - 8/9/18
• Provider Review Results by Provider Type FY18 Q2 - 8/9/18
• Provider Review Results by Provider Type FY18 Q3 - 11/15/18
• Provider Review Results by Provider Type FY18 Q4 - 11/15/18
• Provider Review Results by Provider Type FY19 Q1 - 2/14/19

Recovery Audit Contractor (RAC) Audits

• RAC Review Results by Provider Type - 12/31/16
• RAC Review Process - Updated 6/15/15

• 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. 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 Carter, RAC Program Manager, at yulonda.carter@medicaid.alabama.gov or Beverly Churchwell, Director, at beverly.churchwell@medicaid.alabama.gov.