Medicare Compliance & Reimbursement

Industry Note:

Faulty Reconciliation Policy Cost Feds Millions

Outlier behavior can prove problematic for providers, but also for the federal programs that govern them. Context: After uncovering issues with the Centers for Medicare & Medicaid Services’ (CMS) reconciliation policies for hospitals that received outlier claims payments, the HHS Office of Inspector General (OIG) conducted a study to pinpoint the problem. “Our objective was to determine whether CMS paid [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more