MACs request self-audits for CPAP supplies

Thursday, October 4, 2018

WASHINGTON – Certain providers of CPAP supplies have begun receiving letters from Noridian and CGS, requesting them to conduct self-audits of claims within 180 days, according to a bulletin from AAHomecare. The providers targeted: those associated with overpayments as a result of a recent study by the Office of Inspector General. If providers identify overpayments, they then need to contact the MACs within 60 days after the review to either adjust the claim, send a check for the overpayment amount, or negotiate a repayment plan. The self-audits may be conducted by third-party consultants. The OIG report, published in June, found that, of 110 sample claims that Medicare paid in 2014 and 2015, only 24 complied with Medicare requirements.