Which statement about RACs may not identify improper payments from other programs?

Which statement about RACs may not identify improper payments from other programs?

• A. RACs may identify improper payments from all programs
• B. RACs may not identify improper payments arising from programs other than Medicare Fee-For-Service
• C. RACs only identify underpayments
• D. RACs can only review prepayment claims

Answer: (B)

RACs operate to identify improper payments specifically within the Medicare Fee-For-Service program. Their authority does not extend to other programs, so they cannot identify improper payments arising from programs outside Medicare FFS. Improper payments include both overpayments and underpayments, and RAC activities are focused on reviewing Medicare FFS claims after they’ve been paid (post-payment audits), rather than being limited to prepayment reviews. This is why the statement that RACs may not identify improper payments arising from programs other than Medicare Fee-For-Service is the correct reflection of their scope.

RACs operate to identify improper payments specifically within the Medicare Fee-For-Service program. Their authority does not extend to other programs, so they cannot identify improper payments arising from programs outside Medicare FFS. Improper payments include both overpayments and underpayments, and RAC activities are focused on reviewing Medicare FFS claims after they’ve been paid (post-payment audits), rather than being limited to prepayment reviews. This is why the statement that RACs may not identify improper payments arising from programs other than Medicare Fee-For-Service is the correct reflection of their scope.