Zone Program Integrity Contractors

Court rules that SNF can't skip part of Medicare appeals process

Long-term care providers may not leapfrog standard administrative appeals in Medicare reviews, as one creative Louisiana nursing home was reminded last week.

Medicare claims reviews should be more streamlined, government report states

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The government could improve Medicare oversight by creating a more uniform and unified post-payment review system, according to a report from federal officials.

CMS improperly measuring outcomes, report claims

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So far, some providers have been put through a wringer without enough verification that it's been worth it, according to a new Government Accountability Office report.

CMS fails to measure outcomes of the zone program integrity contractor program: government report

CMS fails to measure outcomes of the zone program integrity contractor program: government report

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The Centers for Medicare & Medicaid Services is not thoroughly assessing how well zone program integrity contractors are contributing to Medicare anti-fraud efforts, according to a new report from the Government Accountability Office.

OIG: Medicare contractors, antipsychotics in SNFs to get a closer look

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The Medicare contractors keeping close tabs on long-term care facilities will be subject to oversight too, according to a federal working plan released this week.

SNF rehab claims scrutinized more than ever, expert says

SNF rehab claims scrutinized more than ever, expert says

Nursing home administrators who can't substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert said Tuesday.

Letter: Provider group accuses CMS of using Medicare audits for 'stealth policymaking' purposes

Letter: Provider group accuses CMS of using Medicare audits for 'stealth policymaking' purposes

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A provider group is taking the Centers for Medicare & Medicaid Services to task for improperly using Medicare audits as a means of curtailing high-intensity therapy in skilled nursing facilities.

Senators: Recovery audit contractors might be doubling up tasks; campaign against fraud gears up

Senators: Recovery audit contractors might be doubling up tasks; campaign against fraud gears up

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Members of the Senate Finance Committee say they are concerned that the functions completed by independent contractors — known as recovery audit contractors (RACs) and Zone Program Integrity Contractors (PICs) — often overlap.