tci Medicare Compliance & Reimbursement - 2009 Issue 20

INDUSTRY NOTES: OIG Finds CMS's CERT Results Inaccurate

Plus: Keep medication units in check with MAC-approved drug calculator tool. Each year, CMS releases its Comprehensive Error Rate Testing (CERT) results, outlining areas where Medicare may have made improper payments. But now it appears that the CERT results themselves may be riddled with errors. The OIG conducted a review of the 2008 CERT results and found that the actual error rate was more than double what CMS's CERT contractor actually found. In some cases, the difference in error rates was due to "professional judgement" regarding how the auditor interpreted the medical documentation, but in other instances, CMS's original...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.