{"abstract":"This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2011/09/16/2011-23695.html","cfr_references":[{"chapter":null,"citation_url":null,"part":455,"title":42}],"citation":"76 FR 57808","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Date: These regulations are effective on January 1, 2012.","disposition_notes":null,"docket_ids":["CMS-6034-F"],"dockets":[],"document_number":"2011-23695","effective_on":"2012-01-01","end_page":57844,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2011/09/16/2011-23695.xml","html_url":"https://www.federalregister.gov/documents/2011/09/16/2011-23695/medicaid-program-recovery-audit-contractors","images":{"ER16SE11.000":{"large":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_large.png","medium":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_medium.png","original_size":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_original_size.png"}},"images_metadata":{"ER16SE11.000":{"large":{"identifier":"ER16SE11.000","content_type":"image/png","size":81578,"width":618,"sha":"d128826e62c846e49acfc4171810d969","url":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_large.png","height":1550},"medium":{"identifier":"ER16SE11.000","content_type":"image/png","size":26557,"width":291,"sha":"35ea9ba0407c67cc970301e16bd8d2d2","url":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_medium.png","height":729},"original_size":{"identifier":"ER16SE11.000","content_type":"image/png","size":123586,"width":2198,"sha":"7961cffb62a9bb4b3fd9b74cb42e8d13","url":"https://img.federalregister.gov/ER16SE11.000/ER16SE11.000_original_size.png","height":5512}}},"json_url":"https://www.federalregister.gov/api/v1/documents/2011-23695?publication_date=2011-09-16","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2011-09-16/2011-23695/mods.xml","not_received_for_publication":null,"page_length":37,"page_views":{"count":6333,"last_updated":"2026-06-24 20:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2011-09-16/pdf/2011-23695.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2011-09-16","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2011/09/16/2011-23695.txt","regulation_id_number_info":{"0938-AQ19":{"issue":"201104","html_url":"https://www.federalregister.gov/regulations/0938-AQ19/medicaid-recovery-audit-contractors-cms-6034-f-","title":"Medicaid Recovery Audit Contractors (CMS-6034-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201104&RIN=0938-AQ19&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AQ19"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-10-06T08:06:24Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":57808,"subtype":null,"title":"Medicaid Program; Recovery Audit Contractors","toc_doc":"Medicaid Program; Recovery Audit Contractors","toc_subject":null,"topics":["Fraud","Grant programs-health","Health facilities","Health professions","Investigations","Medicaid","Reporting and recordkeeping requirements"],"type":"Rule","volume":76}