Tag: claims

OIG: Medicare overpaid HHAs nationally $191.8 million in audit period

A recent OIG report suggests that the MACs could be recouping money they believe was incorrectly paid for home health episodes that ended with five to seven visits, slightly above the LUPA thresholds in PPS. And they could be enforcing stricter oversight of periods just above new LUPA thresholds in PDGM. Twenty out of 25 […]

CMS announces ADR limits updates

CMS has announced that the additional documentation requests (ADR) limits have undergone some changes and will now feature two significant updates. These changes will be effective starting April 15. The first update affects the percent of claim type that the Recovery Auditor can review. Each limit is based on the provider’s Medicare claims volume from […]