Corporate Compliance

Improve your facility’s medical necessity compliance

Healthcare Auditing Weekly, June 14, 2005

Improve your facility's medical necessity compliance

If there's one area of compliance the government will watch for years to come, you can bet on medical necessity. CMS has vowed to lower the percentage of payments for services that don't meet Medicare's medical necessity standards. The latest CMS figures show that 17.2% of all improper payments in fiscal year 2004 (excluding inadequately documented claims) were due to bills for medically unnecessary procedures.

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