Linda Fotheringill

President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. Reaction has ranged from jubilation to threats of violence.

The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program, the first national strategy in the 40-year history of the Medicaid program to promote the fiscal integrity of Medicaid by detecting and preventing provider fraud, waste and abuse.

Providers have been scrambling to get their so-called RAC Tracking System in place. But did you know that Medicare contractors are mandated by CMS to have a Provider Tracking System?

The RAC program is just one of the CMS programs designed to ramp up "benefit integrity" efforts and to otherwise preserve or recoup cash for the trust fund. Providers must be aware of all the alphabet soup measures.

Many providers are planning to appeal all claims wrongfully denied by the RACs, and also are attempting to calculate the financial impact of potential RAC denials within their facilities. Therefore, the time frame within which one can expect a final decision is critical to forecasting.

The RACs certainly have our attention. The MACs (i.e., Fiscal Intermediaries and Carriers and Medicare Administrative Contractors), however, deserve as much if not more of our attention.

As if we don't have enough on our plates with the RAC Medicare Program, our Medicaid revenue undoubtedly soon will be subjected to similar harsh scrutiny.