A CMS antifraud program that kicks off today is targeting hospitals and physicians in Texas and 10 other states. The project allows recovery audit contractors to review the medical necessity of claims before the providers are paid.
The Medicare Recovery Audit Contractor project aims to stop improper fee-for-service payments before they happen. Initial reviews will target hospitals and focus on short inpatient hospital stays.
The efforts will focus on seven states with providers prone to errors and fraud (California, Florida, Illinois, Louisiana, Michigan, New York, and Texas), and four with large volumes of short inpatient hospital stays (Missouri, North Carolina, Ohio, and Pennsylvania).
Here are details on the demonstration program, which was announced Nov. 15, 2011.
