Monthly Archives: February 2013

IG Report: CMS Must Recoup Additional Medicaid Overpayments

Earlier this month CMS Office of Inspector General released a report highlighting CMS’s inability to adequately recoup over payments made to state Medicaid agencies, and by extension, Medicaid providers. The report identified $226 million in unclaimed overpayments in 11 states … Continue reading

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PDAC Revises Definitions for L1906, Removes Height Requirement

Seeking consistency with the DME MAC LCD Policy Article released on January 1, 2013, the Pricing Data Analysis and Coding contractor (PDAC) has revised definitions for L1906, removing a key height requirement that had caused significant issues for prosthetists. Below … Continue reading

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Jurisdiction D External Breast Prosthesis Prepayment Review Findings

Earlier this week Jurisdiction D DME MAC Medical Review Department announced their findings of a widespread prepayment review of L8030. This prepayment review probe was created after the review¬†of a Comprehensive Error Rate Testing (CERT) analysis. Much like the findings … Continue reading

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Senate Finance Committee Releases Report Highlighting Audit Issues

Yesterday a bipartisan group of Senate Finance Committee members released a new report entitled “Opportunities to Curb Waste, Fraud and Abuse in Medicare and Medicaid.” Senators included Baucus (D-MT), Hatch (R-UT), Grassley (R-IA), Carper (D-DE), Wyden (D-OR) and Coburn (R-OK). … Continue reading

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