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Improper Payment Probe

All skilled nursing facilities that participate in Medicare Fee-for-Service (FFS) can expect a letter from the Centers for Medicare & Medicaid Services (CMS) regarding improper payment rates starting June 5. CMS will have its auditors conduct reviews of five claims per SNF – providers with an error rate of 20% or less will receive education of some kind, while those with an error rate greater than 20% will receive one-on-one education with a Medicare Area Contractor (MAC). MACs were directed to start with providers that show the highest risk. See articles below.

Click here to view the CMS Manual System.

Click here to view the Skilled Nursing News article.

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Sarah McIntosh, President