tci Medicare Compliance & Reimbursement - 2021 Issue Q3

Industry Notes: TPE Medical Reviews Are Back in Action

Tip: Check with your MAC for a definite start date. You can expect some extra scrutiny of your Medicare claims, a recent update suggests. Details: On Aug. 12, the Centers for Medicare & Medicaid Services (CMS) announced the resumption of the Targeted Probe & Educate medical review program. “CMS is restarting the Targeted Probe and Educate (TPE) program to help educate providers and reduce future denials and appeals,” the agency said in its MLN Connects newsletter from that date. Reminder: CMS began TPE on a more limited basis in late 2017, and its Probe & Educate program...

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