GAO: Review process rushed

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NASL's Cynthia Morton
NASL's Cynthia Morton

Medicare Administrative Contractors started a manual review process for outpatient therapy claims too quickly, setting the stage for chaos in late 2012, a government review has revealed.

MACs were charged with manually reviewing for approval or denial Part B therapy claims that exceeded $3,700 cap levels.

“It was a mess,” said Cynthia Morton, National Association for the Support of Long-Term Care.

The GAO agreed in its July report, citing inconsistent implementation on things such as how to manage incomplete documentation and how to judge 10-day review frames. 

Regulators say the process, largely taken over Recovery Audit Contractors, is now more streamlined.