Audit of Minnesota Medicaid Reimbursement for Targeted Case Management Services for Fiscal Years 2003 and 2004
Compliance Monitor, November 14, 2007
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
The OIG found the State agency claimed $7,311,860 for Medicaid reimbursement of TCM services that were unallowable.
The OIG recommended that:
- Minnesota refund the Federal Government the $3,759,338 for undocumented and unsupported TCM services
- Ensure that TCM services claimed under the Medicaid program are properly documented and meet Federal and State requirements
The OIG reviewed 118 claims in 100 sample beneficiary-months, and 7 claims were found to be unallowable because the services weren't supported by the case records or they weren't correctly documented.
To read more click here
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Level of encryption needed for email
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Q&A: Acute respiratory failure diagnosis does not require intubation
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- Oxygen Cylinder Storage Requirements
- Q&A: Acute respiratory failure diagnosis does not require intubation
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Understand the spine to code back procedures correctly
- Catch up on what's new with injections and infusions
- Hospitals are not bound by InterQual criteria for determining patient status
- Searched