108C-5.1. Post-payment review and recovery audit contracts.
The Department shall not pay contingent fees pursuant to any contract with an entity conducting Medicaid post-payment reviews or Recovery Audit Contractor (RAC) audits before all appeal rights have been exhausted. Any contingent fee for Medicaid post-payment reviews or RAC audits shall be calculated as a percentage of the amount of the final overpayment, as defined in G.S. 108C-2(5). The State share of the contingent fee paid for Medicaid post-payment reviews or RAC audits shall not exceed the State share of the amount actually recovered by the Department and applied to the final overpayment. (2013-360, s. 12H.16(b).)
Structure North Carolina General Statutes
North Carolina General Statutes
Chapter 108C - Medicaid Provider Requirements
§ 108C-1 - (Effective until contingency met see note) Scope; applicability of this Chapter.
§ 108C-2 - (Effective until contingency met see note) Definitions.
§ 108C-2.1 - Provider application and revalidation fee.
§ 108C-3 - (Effective until contingency met see note) Medicaid and Health Choice provider screening.
§ 108C-5 - Payment suspension and audits utilizing extrapolation.
§ 108C-5.1 - Post-payment review and recovery audit contracts.
§ 108C-6 - Agents, clearinghouses, and alternate payees; registration required.
§ 108C-7 - Prepayment claims review.
§ 108C-8 - (Effective until contingency met see note) Threshold recovery amount.
§ 108C-9 - (Effective until contingency met see note) Provider enrollment criteria.
§ 108C-10 - Change of ownership and successor liability.
§ 108C-11 - Cooperation with investigations and audits.