tci Medicare Compliance & Reimbursement - 2008 Issue 34
CMS Appoints 'Integrity Contractors' To Find Fraud
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Article Overview
This article covers CMS’s announcement of a new Medicare oversight initiative focused on billing trend analysis and program integrity contractors. It is relevant for practices, billing staff, compliance teams, auditors, and other healthcare professionals who want to understand the general direction of Medicare oversight efforts and the types of claims activity CMS says it will review. The article also notes how the initiative relates to Medicare parts and to other contractor-based review programs.
Why This Topic Matters
The piece helps readers understand a Medicare compliance and audit trend that may affect practices with unusual billing patterns. It provides context for why claims activity is being monitored and how CMS describes its oversight approach.
What You Will Learn
- The purpose of CMS’s new Medicare integrity oversight initiative
- How billing patterns and claims trends are being used in oversight efforts
- Which broad Medicare parts are mentioned in connection with the contractor program
- How the initiative is positioned relative to other contractor-based review models
Who Should Read This
- Physicians and medical practice owners
- Medical billers and coders
- Compliance officers
- Healthcare auditors
- Practice administrators
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