Which term refers to a network of individuals who identify Medicare underpayments and overpayments?

• A. HIPPA
• B. DME
• C. Medicare Recovery Audit Contractor Program
• D. Kickback

Answer: (C)

The network described is the Medicare Recovery Audit Contractor Program. RACs are private auditors contracted by CMS to review Medicare claims after payment. Their job is to detect improper payments and recover funds, which includes identifying instances where payments were too low (underpayments) or too high (overpayments) and correcting them to improve overall program integrity.

HIPAA covers privacy and security of health information, not auditing for improper payments. DME refers to durable medical equipment and is not about auditing Medicare payments. Kickback involves illegal payments to influence referrals and does not describe a network that audits payments.