GAO study identifies strategies for CMS to reduce improper payments, offers Medicaid RAC program update
Recovery Auditor Report, March 24, 2011
A Government Accountability Office (GAO) study released March 9 identifies five ways in which GAO recommendations and recent laws, as well as other agency actions, can help CMS reduce Medicare and Medicaid fraud, waste, abuse, and improper payments.
Based on GAO reports from 2004 through 2010, the study found CMS should employ the following five strategies:
- Strengthen provider enrollment standards and procedures
- Improve prepayment claim review
- Focus post-payment claims review on the most vulnerable areas and add additional recovery audit RACs
- Improve contractor oversight
- Develop a robust process for addressing identified vulnerabilities
Included in the study was a minor update on the status of Medicaid RACs. Fifty-five state Medicaid agencies have submitted plans for addressing the Medicaid RAC Patient Protection and Affordable Care Act (PPACA) provision as of February, CMS officials told the GAO. Fourteen states have asked for exceptions in part or in whole. CMS plans to make public its decisions on any exceptions granted, according to the GAO.
To view the GAO study, click here.
Related Products
Most Popular
- Articles
-
- CMS seeks comment on quality measures
- Practice the six rights of medication administration
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Nursing responsibilities for managing pain
- CMS creates web portal for questions about 1135 waivers, PHE
- Q&A: Primary, principal, and secondary diagnoses
- ICD-10-CM coma, stroke codes require more specific documentation
- OB services: Coding inside and outside of the package
- The consequences of an incomplete medical record
- E-mailed
-
- Coronavirus vaccination: 4 best practices for communicating with patients
- Q&A: Pressure ulcer POA code confusion resolved
- Neurological checks for head injuries
- Keyes Q&A: Generator lighting, fire dampers, eyewash stations, ISLM fire drills
- Including 46600 in E/M leveling systems
- How to get reimbursed for restorative nursing
- Fetal non-stress tests represent important part of maternal and fetal health
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Coding tip: Know how to correctly code each procedure an otolaryngologist can perform on turbinates
- Coding Clinic reiterates guidelines for provider documentation
- Searched