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Medicare Compliance & Reimbursement

Industry Note:

Faulty Reconciliation Policy Cost Feds Millions

Outlier behavior can prove problematic for providers, but also for the federal programs that govern them. Context: After uncovering issues with the Centers for Medicare & Medicaid Services’ (CMS) reconciliation policies for hospitals that received outlier claims payments, the HHS Office of Inspector General (OIG) conducted a study to pinpoint the problem. “Our objective was to determine whether CMS paid [...]