Medicare Errors: DMEPOS, Home Health, E/M Factor Heavily in the 2015 Fee-For-Service Error Rate

Why This Topic Matters

The article highlights where Medicare improper payments were concentrated in 2015 and shows which service areas drove the largest share of error findings. That makes it relevant for organizations seeking to understand audit exposure, documentation vulnerabilities, and the operational impact of CERT results.

Article Sections

1. Background

   Introduces the CERT-based Medicare fee-for-service review and the types of claim issues identified in the report. Summarizes the scope of the data reviewed and the major payment categories included.

2. Five Measures That Helped

   Describes broad corrective themes discussed in connection with reducing the improper payment rate. Focuses on program-level areas CMS and prior CERT research identified for improvement.

3. Stats and details

   Provides a high-level breakdown of error rates across major Medicare payment categories. Notes the broad trends and distribution of improper payments.

4. Part A issues

   Covers error patterns within Part A claims and the service types that contributed most to the findings. Highlights documentation as a major factor in the reported issues.

5. Part B struggles are real

   Summarizes Part B improper payment findings and the broad documentation problems identified. Reviews the general scale of Part B-related payment errors.

6. Watch Your E/M Claims

   Discusses evaluation and management service error trends and common documentation or coding concerns at a general level. Includes the broad claim-setting contexts referenced in the report.

7. Coding blunders

   Addresses recurring coding and documentation issues associated with certain E/M claims. Notes the general nature of split/shared service concerns and related billing contexts.

8. Texas and Georgia Have the Highest Improper Payment Rates

   Lists the states with the highest reported improper payment rates in the article’s summary of geographic findings. Provides the ranking context without further technical detail.