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CodeMap Compliance Briefing: 01/07/05


 

Editor's Welcome

Welcome back from the holidays. We hope that the new year brings health, wealth, and happiness to all our subscribers. The first CodeMap Compliance Briefing of 2005 will discuss the Medicare payment error rate computed by CMS at the end of each fiscal year. The error rate tracks claims from providers that Medicare has determined were paid in error. We will look at how Medicare develops this measure of provider-caused errors and its potential impact. In addition, this briefing examines a recent GAO report that appears to demonstrate that providers are not the only source of errors. Unsurprisingly, the GAO report indicates that Medicare contractors occasionally make mistakes as well.

Sincerely,

Gregory Root, Esq.

Background: Medicare Payment Error Rate

Since 1996, the Department of Health and Human Services (HHS) has annually determined the error rate for fee-for-service claims paid by Medicare contractors. From 1996 until 2002, the Office of Inspect....

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