Oct 4th, 2017
The Center for Medicare & Medicaid Service’s (CMS) Fraud Prevention System generated 22 percent of investigations initiated by program integrity contractors in 2016. That means if you were audited by zone program integrity contractors (ZPIC), it might’ve been the $192 million data analytics program that raised the flag. ZPIC contractors told the Government Accounting Office ...
In Audit
Jul 1st, 2011
Crooks who choose to defraud Medicare will now have to square up against technology in uniform. Predictive modeling is the Centers for Medicare & Medicaid Services’ (CMS’) newest tool to help an administration-wide campaign to cut waste, fraud, and abuse in Medicare beginning July 1. The initiative uses similar technology to that used by credit card ...
In Coding
Sep 10th, 2010
The Centers for Medicare & Medicaid Services (CMS) issued a final rule Aug. 27 entitled “Medicare Program; establishing Additional Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Enrollment Safeguards (CMS-6036-F).” The final rule implements several Patient Protection and Affordable Care Act (Affordable Care Act) requirements designed to prevent and d...