Update: Post Payment Medical Review Topics

As previously reported, the Centers for Medicare & Medicaid Services (CMS) authorized the resumption of medical reviews to begin in August. Since the original resumption announcement, hospices and home health agencies have learned that medical reviews administered by the Medicare Administrative Contractors (MACs) will be service-specific post payment reviews. NOTE: Targeted Probe & Educate (TPE)…

OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies

CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home…