MedicaidAdministrativeMedium impact
Centers for Medicare and Medicaid Services-Mandated Recovery Audit Contractor to Begin Auditing
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
We identified it
Jun 20, 2026
Summary
Wisconsin has established a Recovery Audit Contractor (RAC) program through Health Management Systems, Inc. (HMS) to audit Medicaid and BadgerCare Plus claim payments for improper payments. Any provider may be selected for audit based on data analysis, and providers must comply with audit requests including providing records and facility access.
Action Required
Immediately: Billing team should save HMS contact information (800) 310-0865 and website (www.medicaid-rac.com) for future reference. Ensure all Medicaid and BadgerCare Plus claims have proper documentation and that services were actually provided as billed. If audit notification is received, respond within requested timeframes and designate staff to coordinate with HMS auditors for record requests and facility access.