tci Part B Insider - 2021 Issue Q1

Improper Payment Rate: ‘Corrective Actions’ Decrease Overall Rates

Hint: Inadequate documentation remains a problem. If you’ve been waiting patiently for Medicare’s improper payment rate estimates, you’re in luck. Even though the data points to rate declines from federal corrective actions, improper payments are estimated in the billions. Context: On Nov. 16, the Centers for Medicare & Medicaid Services (CMS) announced the fiscal year (FY) 2020 estimated improper payment rates. As part of its Comprehensive Error Rate Testing (CERT) program, CMS publishes the CERT report, which breaks down the biggest errors among Medicare fee-for-service (FFS) claims and covers the causes of the improperly paid charges...

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