States Using Statistical Extrapolation with Medicaid Audits
- New Jersey;
- New York;
- North Carolina;
- Rhode Island may be using extrapolation in the future.
States NOT Using Statistical Extrapolation with Medicaid Audits:
- New Hampshire;
- West Virginia;
Under the Affordable Care Act (*) states contract with Recovery Audit Contractors (RACs) to identify under and over-payments and recoup the over-payments.
Medicaid Integrity Contractors (MMICs) work out of five jurisdictions:
- New York (CMS Regions I & II)
- Atlanta (CMS Regions III & IV)
- Chicago (CMS Regions V & VII
- Dallas (CMS Regions VI & VIII)
- San Francisco (CMS Regions IX & X)
(*) Affordable Care Act was passed by Congress and signed into law 23 March 2010. It was reviewed by the Supreme Court and was upheld. See USSC, National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al. Syllabus, October, 2011.