tci Medicare Compliance & Reimbursement - 2021 Issue Q1

Check Out These CERT Statistics

Here’s a breakdown of the Medicare fee-for-service overall improper payment rate projections for fiscal year (FY) 2020: Part A with Hospital IPPS: The feds found a 14 percent improper payment rate among Medicare Part A with hospital inpatient prospective payment system (IPPS) claims. Part A without Hospital IPPS: A staggering 42.4 percent of Medicare Part A excluding hospital IPPS claims were part of the overall error rate. Despite this high number, this category saw a big decline in 2020, dropping down from 46.1 percent in 2019. Part B: The CERT data showed Medicare Part B’s...

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