Our Products can help your organization stay educated and compliant. Shop Now >

Insights

New OIG Report Shows That Insufficient Documentation is the Primary Cause of Medicare Fee-for-Service Improper Payments in FY2015

Posted on Monday, May 16, 2016 1:25 PM

A report by the Department of Health and Human Services Office of Inspector General (OIG) proves that insufficient documentation in home health is the main cause of Medicare fee-for-service improper payments. The report tracked a federal audit that concluded $268 million in 2015 was improperly billed Medicare.

In summary, HHS was unsuccessful in meeting a number of goals. Under IPIA, the Medicare fee-for-service error rate percentage should not have surpassed 10% in 2015. The rate was 12.9% for the fiscal year.

“HHS documented that insufficient documentation was particularly prevalent for home health claims,” the report findings read.

The OIG’s recommend the following for HHS:
• “Proactively take action” for the upcoming fiscal year
• Establish target rates for improper payments
• Improve communication between federal payers and providers

For the full article, click here.


About Corridor

Corridor is a trusted home health and hospice consulting partner to agencies both large and small. We provide the most up-to-date comprehensive homecare industry educational resources and consulting available.

We specialize in delivering better revenue cycle management solutions, coding and documentation review services, regulatory compliance, and healthcare consulting.

For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

For additional information, please contact Corridor at 1-866-263-3795

Go Back