OIG Recommends Reviews Of Claims From Individual Clinicians With High Cumulative Medicare Payments
The Office of the Inspector General (OIG) for the federal Department of Health and Human Services (HHS) has recommended that there be reviews of high cumulative Medicare billing, including establishing a cumulative payment threshold for review, and a procedure for identifying when clinician’s claims go about that threshold. In response to these recommendations, the federal Centers for Medicare and Medicaid Services (CMS) stated that it work with contractors to research and develop an appropriate cumulative payment threshold that would consider service type and provider specialty . . .