Suppliers reach both ends of error spectrum, CERT report shows.
Home health agencies and hospices are billing Medicare pretty accurately, according to the most recent findings of CMS' Comprehensive Error Rate Testing.
HHAs had a 1.4 percent error rate and hospices a 1.0 percent error rate in the November CERT report, which covers claims from April 2006 to March 2007.
Durable medical equipment suppliers had a wide range of error rates broken out by supplier type. The lowest was 0.6 percent for a medical supply company with prosthetic/orthotic personnel certified by an accrediting organization. The highest was a whopping 51 percent for "unknown supplier/provider."
Overall, the national error rate for Medicare was 3.9 percent, CMS says in the report. That translates to $10.8 billion in improper payments, $1 billion of which was underpayments, the report says.
That figure is down from 4.4 percent last year.
The report is online at
www.cms.hhs.gov/CERT --click on "CERT Reports" in the left-hand column and choose the "Improper Medicare FFS Payments" link and then "FY 2007 Long Report." • In all the PPS revisions hullabaloo, don't forget about another big change advancing with the new year--the CARE tool. The Centers for Medicare & Medicaid Services will have providers testing the post-acute Continuity Assessment Record and Eval-uation (CARE) assessment tool in a demonstration project starting in January.
The tool, which CMS intends all post-acute care providers to fill out eventually, is meant to examine the costs and outcomes for similar diagnoses across different post-acute care settings (see Eli's HCW, Vol. XVI, No. 27).
CMS is already gearing up for the tool to become standard for all HHAs, noted the agency's Pat Sevast at a recent OASIS Certificate and Competency Board annual meeting in Baltimore.
Example: In the proposed changes to the OASIS tool that just wrapped up its second comment period, CMS revised the wording of some of the OASIS items to be closer to the proposed CARE tool items, Sevast told attendees.
• CMS has rounded up its technical corrections to the PPS refinements final rule in a Nov. 30 Federal Register notice. The agency made official changes to charts, calculations, code descriptors, wage index values and more. See the notice at
www.access.gpo.gov/su_docs/fedreg/a071130c.html --scroll down to the CMS entries. • You soon may be tapped to give your two cents about your Medicare contractor. CMS will send its third annual Medicare Contractor Provider Satisfac-tion Survey (MCPSS) to a new sample of Medicare providers this month, it says in a release.
The agency is distributing the 15-minute survey to about 35,000 randomly selected providers of all types, it says. CMS will use the survey "as an additional measure to evaluate performance," the release notes. "In fact, all Medicare Administrative Contractors (MACs) will [...]
