Home Health & Hospice Week
CERT Report Pushes Prior Auth
Only DME rivals the home health error rate.
The “Medicare Fee-for-Service 2015 Improper Payment Report” that Medicare, the Medicare Payment Advisory Commission, and others have been citing for months is officially out. The Centers for Medicare & Medicaid Services posted the report based on Comprehensive Error Rate Testing reviews, which holds the infamous 59 percent error rate for home health claims reviewed, at www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFSCompliance-Programs/CERT/Downloads/2015_Improper_Payments_Report.pdf last month.
Overall, CMS saw a decreased fee-for-service improper error rate from 12.5 percent to 12.1 percent from 2014 to 2015. Most other provider types saw single-digit error rates, or at least those in the low teens. The exception was Durable Medical Equipment suppliers with a 40 percent error rate.
Not surprisingly, the report advocates “expanded use of prior authorization in the Medicare FFS program.”
Home Health & Hospice Week
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New Outlier Calculation Misses The Mark
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Beware More Outlier Fraud
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CERT Report Pushes Prior Auth
Only DME rivals the home health error rate. The “Medicare Fee-for-Service 2015 Improper Payment Report” [...] - Industry Note:
Publicly Traded Home Care Company To Buy Controlling Interest In 89-Location Health System-Based Chain
Almost Family Inc. is buying the controlling interesting in an 89-location health systembased home health [...]
