Tag: Improper payment rate

WASHINGTON – The improper payment rate for DMEPOS was 28.6% from July 2019 through June 2020, a 3.2% decrease from the prior year, according to the latest 2021 Medicare Fee-for-Service Supplemental Improper Payment Data Report from CMS. The improper payment rate varies by product category, AAHomecare pointed out in a bulletin, from 8.8% for power wheelchairs to 40.8% for enteral nutrition. CPAP devices and oxygen concentrators had improper payment rates of 30.8% and 22.3%, respectively. The...

WASHINGTON – Noridian Healthcare Solutions, the Supplemental Medical Review Contractor for CMS, is conducting post-payment reviews of claims for surgical dressings billed on dates of service from Jan. 1, 2019, through Dec. 31, 2019. Surgical dressings are ranked in the top four categories with the highest improper payment rate at 62.8%, according to the 2019 Comprehensive Error Rate Testing Improper Payment Report. Medicare provides reimbursement for surgical dressings under the DMEPOS benefit,...

WASHINGTON - CMS says its aggressive corrective actions have led to an estimated $15 billion reduction in Medicare fee-for-service improper payments since 2016. The Medicare fee-for-service estimated improper rate decreased to 6.27% in fiscal year 2020, compared to 7.25% in FY 2019, the fourth consecutive year the rate has been below the 10% threshold for compliance established in the Payment Integrity Information Act of 2019. “We must ensure that fraud and abuse doesn't rob the program of...