CMS To Audit Costly Medical Procedures To Reduce Waste
CMS is boosting efforts to curb unnecessary treatments through a demonstration project that will assess the appropriateness of certain procedures before issuing payments. In November, the agency announced four Medicare and Medicaid payment demonstration projects as part of the "Campaign to Cut Waste," a national effort to prevent improper payments by federal programs such as Medicare and Medicaid. A CMS fact sheet about the "Recovery Audit Prepayment Review" project -- which seeks to revise the current "pay-and-chase" model of identifying improper payments -- will be implemented in seven states with high populations of fraud- and error-prone providers, including California, and four states with high claims volumes of short inpatient hospital stays.
- "CMS Tightening the Screws on Unnecessary Procedures in Florida and 10 Other States" (Husten, Forbes, 12/4).
- "Hospitals Tumble on Medicare Order for Heart Procedure Audit" (Wechsler/Fay Cortez, Bloomberg/San Francisco Chronicle, 12/4).