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The anticipated issue date for the new audit is the 2024 fiscal year. Citing “consistently high error rates,” federal officials announced this week that
Three quick stories, each of Medicare money that has vanished, never to be found. First, a report from the U.S. Department of Health and Human
Medicare does not provide funding for financial losses. When natural disasters strike, Medicare and Medicaid audits become less important, and human safety becomes most important.
Always challenge the extrapolation. It is my opinion that extrapolation is used too loosely in healthcare audits. What I mean is that sample sizes are
Two key insurers were recently targeted for HHS OIG scrutiny. I was all set to dive into the September audits of HumanaChoice and BlueCross Blue
The application of precision medicine, along with diagnostic testing, is expected to save billions of dollars. The patient has cancer. Difficult to treat. An available
Audits reveal recurring problems in which there is room for improvement. Last week was a busy week for the Office of the Inspector General (OIG).
Five years ago, the Centers for Medicare & Medicaid Services (CMS) first compiled a list of services that the newly implemented recovery audit contractor (RAC)
Double-dipping has been seen among some Managed Care Organizations. How many readers have undergone more than one audit? What about more than one audit for
Complaints are abundant from beneficiaries. Last week saw the release of another audit of a Medicare Advantage (MA) plan from the U.S. Department of Health
Recently, the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) released an interesting audit. They audited billing of
Learn how MACs piggyback on RAC audits. A question that I get often is “Do I have to submit the same medical records to my
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