The Texas Health and Human Services Commission (HHSC) has announced a "tentative contract award" for the Recovery Audit Contractor (RAC) Program for Texas Medicaid to CGI, Federal, Inc. CGI is currently the Medicare RAC for Region B, and has been awarded the Medicaid RAC contract for Ohio and Colorado. Section 6411(a) of PPACA expanded the RAC program to Medicaid and requires each state Medicaid program to establish a RAC program for auditing Medicaid claims submitted by providers. The HHSC award is contingent upon the successful negotiation and execution of a contract.
According to the Final Rule, states are required to implement their respective RAC programs by January 1, 2012. The Centers for Medicare and Medicaid Services clarified that their expectation of "implementation" was for states to have a signed contract in place with its selected RAC vendor by January 1, 2012, unless an exception was requested. HHSC recently published a notice in the Texas Register announcing its intent to submit an amendment to the Texas State Plan for Medical Assistance to request a delay in implementation of the RAC program. The amendment would be effective January 1, 2012. HHSC expects that "the program may not be fully implemented until June 1, 2012."