Medicare Errors: DMEPOS, Home Health, E/M Factor Heavily in the 2015 Fee-For-Service Error Rate
Though CERT data helped decrease errors, improper payments are still in the billions.
With five distinct components in place garnered from extensive Comprehensive Error Rate Testing (CERT) data, CMS saw a decreased fee-for-service improper error rate from 12.5 percent to 12.1 percent from 2014 to 2015. The adjusted rate did make a difference of about $1.4 billion, but the total outlay of improper Medicare payments still reached around $43.3 billion, a hefty sum by any standard.
Background.To create the most recent CERT report, CMS reviewed 49,603 claims, including Part A—with and without...
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: