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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 recommended that CMS correct its CWF edits to ensure that the edits use the home health services on each line within a home health claim rather than only the first line, which will allow the edits to capture home health claims that overlap a hospital stay.
Recommendation Number
269167
Recommendation Status
Open
Significant Recommendation
No
Recommendation Questioned Costs
$0
Recommendation Funds for Better Use
$0
Associated Report Details
Submitting OIG
Department of Health & Human Services OIG
Linked Report
Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services