Industry Notes

Why This Topic Matters

It helps readers gauge current Medicare audit focus areas and understand broader CMS payment trends that may affect documentation, claims review, and incentive participation.

Article Sections

1. Hospice documentation and terminal diagnosis guidance

   Discusses CMS commentary on documentation and coverage concerns for hospice services billed in relation to terminal conditions. The section focuses on how regional offices are reviewing hospice-related payment issues.

2. RAC overpayment and underpayment activity

   Summarizes national recovery audit contractor results for a recent reporting period. It covers the overall volume of incorrect Medicare payments identified and the return of funds to providers.

3. Example of a RAC finding

   Provides a brief illustration of one type of billing error identified in the audit report. The example is used to show the kind of payment issue reviewed by auditors.

4. PQRS and ePrescribing incentive payments

   Reviews CMS reporting on incentive program payments made to physicians and other eligible professionals. The section highlights the programs’ broader purpose and the settings where most payments were made.