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Where To Report Waste
Fraud, Abuse, Or Retaliation
Where To Report Waste Fraud, Abuse, Or Retaliation
Recommendation Details
Text of Recommendation
We recommend that the Centers for Medicare & Medicaid Services instruct MACs to implement edits in their claims processing systems to prevent an OTP from being paid for: (1) a weekly bundle with a service date that was within a contiguous 7-day period of another weekly bundle's service date for the same enrollee at the same OTP or (2) two weekly bundles with the same service date for the same enrollee at the same OTP.
Recommendation Number
23-A-09-103.03
Recommendation Status
Open
Significant Recommendation
No
Recommendation Questioned Costs
$0
Recommendation Funds for Better Use
$0