tci Medicare Compliance & Reimbursement - 2020 Issue Q2

Reader Question: Feds Offer a Pass on Medicare Claims Reviews During Pandemic

Question: We keep checking our Medicare carrier’s website for the Targeted Probe and Educate hot topics list, but there’s been nothing in months. Is the program over? SuperCoder Subscriber Answer: According to Centers for Medicare & Medicaid Services (CMS) guidance, Medicare fee-for-service (FFS) claims reviews are suspended due to COVID-19. Details: At least for now, CMS has halted its pre- and post-payment review programs for the duration of the public health emergency (PHE), so that providers can focus primarily on their patients and combating the virus. “Targeted Probe and Educate (TPE) reviews have been temporarily postponed...

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