tci Medicare Compliance & Reimbursement - 2020 Issue Q3

Industry Notes: Claims Reviews Slated to Restart in August

If reports are accurate, the Medicare claims review reprieve may be coming to an end — sooner rather than later. Details: In the July update of its COVID-19 Provider Burden frequently asked questions (FAQs) set, the Centers for Medicare & Medicaid Services (CMS) still lists Aug. 3 as the date when the agency will lift its claims review enforcement discretion. “On March 30 CMS suspended most Medicare fee-for-service (FFS) medical review because of the COVID-19 pandemic,” the FAQs reminds. “This included prepayment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate...

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