Medical Group Management Association
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Government Advocacy

The voice of medical practices in Washington

Engage with a team that advocates on your behalf and translates complex regulations into focused updates on the latest health issues from Washington.

Medicare Audits and Appeals


Patient protection and Affordable Care Act (ACA): Expansion of the RAC program

  • After 2010, HHS shall contract with RACs to ensure that each Medicare Advantage plan under Part C and each Prescription Drug Plan under Part D have an effective anti-fraud plan in place.
  • Before 2011, state Medicaid agencies must contract with one or more RACs, which will identify underpayments and overpayments, and recover overpayments made for services provided under state Medicaid plans as well as state plan waivers.

Sample Recovery Audit Contractor (RAC) letters issued by Medicare Administrative Contractors (MACs)

Sample RAC demand letter
Sample intent to refer letter

MGMA resources

Other outside resources

CMS standard forms for filing RAC appeals



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