Home Health & Hospice Week

With the flurry of audits that have hit home health and hospice providers lately, you might have lost track of the CERT program. Now Medicare wants to remind you.

“CMS created the Comprehensive Error Rate Testing (CERT) Program to measure the Fee-for-Service payment error rate,” the agency says in a recent message to providers. “This identifies payments that don’t meet Medicare requirements; it doesn’t indicate fraud,” the agency allows.

There are two current CERT contractors — review contractor NCI Information Systems Inc. and statistical contractor The Lewin Group Inc., CMS explains.

“Each reporting year contains claims submitted July 1 two years before the report through June 30 one year before the report,” CMS details. “For example, reporting year 2022 contains claims submitted July 1, 2020 through June 30, 2021.”

Reminder: Hospices’ error rate was up significantly to 12.04 percent for 2022, while HHAs’ rate fell a hair to 10.15 percent (see more details in HHHW by AAPC, Vol. XXXII, No. 2).