The Department of Health and Human Services announced CMS approved state Plan amendment 25-0010: Recovery Audit Contractor, waiving the requirement to implement a Recovery Audit Contractor for an additional two years effective December 1, 2025, through November 30, 2027. Neb Rev Stat 68-974(3)(a) excludes Managed Care claims from the scope of the Recovery Audit Contractor. Recall, the state implemented Heritage Health, combining physical health, behavioral health and pharmacy programs into a single managed care system, effective January 1, 2017.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.