Medicare Compliance & Reimbursement

CERT results reveal $34.3 billion in improper Medicare payments -- $1.1 billion of which was underpaid. If your practice's collections rate was off by 10.5 percent, you'd be in big trouble, right? Well, that's the 2010 Medicare Fee-for-Service improper payment rate, and your MAC may come looking for money you still owe to them. CMS's new Comprehensive Error Rate Testing (CERT) results, which were released in November, show that practices actually made fewer errors in 2010 than in the previous year. Most of the errors were discovered as overpayments -- meaning that CMS identified $33.2 billion that went out to Medicare providers in error, and chances are high that MACs will be asking for much of that money back, if they haven't already. In addition, CMS noted that it still owes $1.1 billion to providers who were underpaid in 2010. To create the CERT report, CMS reviewed 30,965 Part B claims, along [...]