The focus was further refined to assess the use of NPIs particularly as it applied to ordering of “high-risk services” which the OIG defined as “durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) clinical laboratory services imaging services and home health services”.īackground Note: CMS requires MAOs to implement effective compliance program which includes actions to safeguard the MA program from fraud, waste, and abuse. The purpose was to determine the extent to which MAOs used ordering provider NPIs as part of their program integrity activities to identify patterns of inappropriate billing and ordering by providers for their Medicare patients. The OIG administered an online survey to a random sample of 200 MAOs from February to March 2020. The scope of this article is to both review those findings of this April 2021 OIG issuance as well as to revisit the basics on NPIs and why they a critical asset for provider identification and fraud detection. As a result, the OIG has issued several recommendations but it remains unknown whether CMS will enact the changes necessary to mandate the use of NPIs in fraud detection by MAOs. The audit results were illuminating if not entirely encouraging.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |