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CMS revises scope of review on redeterminations and reconsiderations

May 13, 2016HME News Staff

WASHINGTON - CMS has expanded the limits on the scope of review for redeterminations and reconsiderations to include complex prepayment audits, AAHomecare has announced. CMS's initial instructions to the MACs and QICs applied the limits to post-payment reviews. AAHomecare worked with CMS on revised instructions that read: “For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a...

aahomecare, Audits, Limit scope


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