tci Medicare Compliance & Reimbursement - 2022 Issue Q2

Reader Questions: Know the Facts on Medicare and Medical Records Reviews

Question: Since the COVID-19 public health emergency (PHE) is still ongoing, and many have suggested it will be extended through the end of the year, does our practice really need to worry about medical record reviews by the Centers for Medicare & Medicaid Services (CMS)? New York Subscriber Answer: Although CMS put many investigations and reviews on pause during the pandemic, the agency is again looking into medical record reviews. The agency may be looking at medical records of Medicare Parts A and B beneficiaries through additional development requests (ADRs) and Targeted Probe and Educate (TPE) programs for rationale...

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