Other Issuances: RAC program moves forward, OIG releases audit reports
Medicare Weekly Update, February 10, 2009
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CMS resolves RAC protest; permanent program moves forward
On February 6, CMS announced that the permanent RAC program is once again underway as the RAC bid protests filed by Viant, Inc., and PRG Schultz, USA, Inc. have been withdrawn. Viant and PRG’s protests were resolved February 4, which means the stop work order has been lifted.
As a result of the protest settlements, these RACs will be subcontracting with PRG-Schultz and Viant. (PRG-Schultz will work with Diversified Collection Services in Region A, CGI in region B, and HealthDataInsights in Region D. Viant Payment Systems will work with Connolly Consulting in Region C.) PRG-Schultz and Viant will have different responsibilities—including possible claim review—in the various regions.
CMS clarifies policy on CLIA certificates for entities with multiple sites
On February 6, CMS issued a clarification of its policies and procedures for entities with one CLIA certificate for multiple sites.
OIG issues reports on oxaliplatin billing
On February 2, the OIG released a report on oxaliplatin billing at San Angelo Community Medical Center. The OIG found that San Angelo received overpayments totaling $233,000 in 2004. On February 6, the OIG issued a report on oxaliplatin billing at Lovelace Medical Genter – Gibson. The OIG found that Lovelace received overpayments totaling $128,000 in 2004.
View the OIG report regarding San Angelo Community Medical Center.
View the OIG report regarding Lovelace Medical Center - Gibson.
OIG issues review of high-dollar payments for Medicare outpatient claims processed by TriSpan Health Services for the period January 1 through December 31, 2005
On February 2, the OIG issued a report on high-dollar outpatient claims processed by TriSpan Health Services. The OIG determined that TriSpan overpaid providers $782,000 in 2005.
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