Enhanced CMS Oversight in 4 States Yields 40% Claims Denial Rate

The U.S. Centers for Medicare & Medicaid Services’ (CMS) period of enhanced oversight for hospices in California, Nevada, Arizona and Texas has resulted in nearly $456,000 in claims denials to date. Cumulatively, the Medicare Administrative Contractor (MAC) company Palmetto found 330 claims with edit effectiveness through a pre-payment review, 99 of which were denied. This […]