Home Health & Hospice Week

Home health deemed 'high risk' in new report. Changing standards for Medicare's payment error rate reports are giving durable medical equipment suppliers a bad name. The Centers for Medicare & Medicaid Services toughened up its medical review procedures for the latest Comprehensive Error Rate Testing (CERT) report, now called the Improper Medicare Fee-For-Service Payments report. Old way: The CERT contractor reviewers formerly looked at many elements including the clinical record and previous billings to determine a claim's validity. New way: "Now, CERT requires medical records from the treating physician and does not review other available documentation or apply clinical review judgment," according to the report for fiscal year 2009. The records must include valid signatures as well, CMS says -- no stamps, for example. The result: The FY 2009 report doesn't break out error rates by provider type, but it does list them by contractor type. The error rate for DME [...]