tci Medicare Compliance & Reimbursement - 2005 Issue 18

ENFORCEMENT WATCH: High Admin Costs Will Atrract Curious Auditors

The feds don't limit billing investigations to medical procedure claims. Medicare says adequate cost control procedures can save providers from the kind of scrutiny one health care company faced.In an audit of United HealthCare Insurance Company's (UHC) Final Administrative Cost Proposals, the HHS Office of Inspector General (OIG) found more than $12 million of noncompliant claims filed from 1997 to 2000, according to a March 25 press release. The Centers for Medicare and Medicaid Services says it won't reimburse for these claims for Medicare Parts A and B, Railroad Retirement Board and the durable medical equipment...

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