Skip to main content

VGM & ASSOCIATESHealthcare MSO

Search GO

Search GO

LEARN ABOUT VGM

Out With The Old RAC, In With The New

Published in Government Relations on June 03, 2025

On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 3 includes the following Medicare Administrative Contractor (MAC) jurisdictions: JJ, JM, and JN. RAC Region 4 includes jurisdictions: JE, JF, and JL. And RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM. 

In RAC Regions 3 and 4, Cotiviti GOV Services LLC is the incumbent. Performant, the RAC previously responsible for reviews in RAC Region 5, remains under contract with CMS to support the RAC Program from an administrative and appeals perspective in this region, while Cotiviti GOV Services LLC will soon start active reviews.

In all the three newly awarded RAC Regions, CMS anticipates Cotiviti GOV Services LLC will begin reviews in the summer. RAC Region 5 providers can rely on the review completion date specified in the review results letter, as well as the RAC’s name on the letter, to identify which contractor to reach for inquiries. If Performant receives inquiries regarding reviews conducted by Cotiviti GOV Services LLC, Performant customer service will inform providers to reach out to Cotiviti GOV Services LLC and vice versa.

Medicare Fee for Service Recovery Audit Program | CMS

From Our Experts

John Quinlan Named 2026 Van G. Miller Homecare Champion thumbnail

John Quinlan Named 2026 Van G. Miller Homecare Champion AAHomecare announced earlier this week that John Quinlan of Quinlan's Pharmacy in New York has been selected as the recipient of this year's Van G. Miller Award. John has been a valued VGM member for many years, and his leadership within the DMEPOS community has made a meaningful impact on patients, providers, and the industry as a whole. His commitment to quality care, patient access, and industry advocacy consistently sets him apart.

Legislative Update On DMEPOS Bills – Letter To CMS Admin Dr. Oz To Delay Competitive Bidding Program thumbnail

Legislative Update On DMEPOS Bills – Letter To CMS Admin Dr. Oz To Delay Competitive Bidding Program Many of you have already contacted your legislators in support of key DME legislation, including the DMEPOS Relief Act, the Choices for Increased Mobility Act, and the Supplemental Oxygen Access Reform (SOAR) Act. We now have another important issue to bring to your attention.

CMS Revises Nebulizer Policy and ABN Form thumbnail

CMS Revises Nebulizer Policy and ABN Form CMS has issued an update regarding revisions to the CMS Nebulizer Policy Article and guidance on the Advanced Beneficiary Notice of Noncoverage (ABN) Form. For dates of service on or after Feb. 1, 2026, suppliers must include the KX, GA, or GZ modifier to claims for the following nebulizer items:

CMS Releases Updated Telehealth FAQ After Funding Bill Extends Flexibilities Through 2027 thumbnail

CMS Releases Updated Telehealth FAQ After Funding Bill Extends Flexibilities Through 2027 Earlier this week, Congress extended Medicare telehealth flexibilities through Dec, 31, 2027, as part of the newly signed federal funding bill. In response, CMS has released updated Telehealth Frequently Asked Questions (FAQ) to provide clarity on what the extension means for both patients and providers.

Shutdown Ends, Telehealth Prevails as Pres. Trump Signs Funding Bill thumbnail

Shutdown Ends, Telehealth Prevails as Pres. Trump Signs Funding Bill The four-day partial federal government shutdown officially ended on Feb. 3, 2026, after President Donald Trump signed a $1.2 trillion funding package that reopens most federal agencies and restores key programs.

CMS Releases New HCPCS thumbnail

CMS Releases New HCPCS The Centers for Medicare & Medicaid Services (CMS) released an update adding eight new oxygen HCPCS codes to the Required Face-to-Face and Written Order Prior to Delivery List and adding five new orthoses and two HCPCS codes to the Required Prior Authorization List. The changes go into effect April 13, 2026.

Meet the Candidates: Rep. Ashley Hinson Visits VGM During U.S. Senate Campaign thumbnail

Meet the Candidates: Rep. Ashley Hinson Visits VGM During U.S. Senate Campaign Waterloo, Iowa — On Wednesday, VGM Group welcomed employees, local DME suppliers, and community guests for the latest installment of its Meet the Candidates series. The featured guest was Rep. Ashley Hinson (R-IA), who currently represents Iowa's 2nd Congressional District and is now running for the U.S. Senate following Sen. Joni Ernst's decision not to seek reelection in 2026.

Grassroots Accountability Program Wants YOU! Become a DMEPOS Advocate thumbnail

Grassroots Accountability Program Wants YOU! Become a DMEPOS Advocate Are you interested in politics or curious about how government really works behind the scenes The Grassroots Accountability Program (GAP) is a great opportunity to expand your civic knowledge, build meaningful relationships with your state and federal legislators, and make a direct impact on the future of the DMEPOS industry.

Give your business an advantage over the competition.

Become a Member