Recovery Auditor overpayment and underpayment statistics are released by CMS at the close of each fiscal year (FY) quarter, and with FY 2012 in the books, CMS has published its year-end improper payment figures. In FY 2012, the numbers continued to ascend, as CMS more than doubled its total correction amount from the previous year.
Law enforcement officials in Texas, Florida, and New York recently announced plea agreements and fines involving the billing of an unapproved prescription drug and Medicare fraud.
Ensuring detailed documentation isn't important only with respect to documenting medical necessity. Case managers should also ensure physicians are including enough information in patient records to help them accurately estimate length of stay (LOS), says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.