Inspector General Open Recommendations
11/22/2022 - Department of Health & Human Services Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers Audit - Open Recommendations
We recommend that the Centers for Medicare & Medicaid Services recover the portion of the $56,016 in Medicare Part B overpayments that are within the 4-year claim reopening period—including $31,545 in overpayments for the 69 incorrectly billed statistically sampled services and $24,471 in overpayments for the 62 incorrectly billed corresponding services.
11/22/2022 - Department of Health & Human Services Medicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning Audit - Open Recommendations
The Centers for Medicare & Medicaid Services should instruct the MACs, based on the results of this audit, to notify appropriate providers (i.e., those for whom CMS determines that this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence in identifying, reporting, and returning any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.
The Centers for Medicare & Medicaid Services should educate providers on documentation and time requirements for ACP services to comply with Federal requirements. (That is, when another service is performed concurrently with a time-based service, the time associated with the concurrent service should not be included in the time used for reporting the time-based service, and time and ACP discussion must be documented). Had the requirements been followed, Medicare could have saved an estimated $42,266,931 during our audit period.
11/21/2022 - Department of Veterans Affairs Deficiencies in Lethal Means Safety Training, Firearms Access Assessment, and Safety Planning for Patients with Suicidal Behaviors by Firearm Open Recommendations
11/19/2022 - AmeriCorps Audit of AmeriCorps’ Fiscal Year 2022 Consolidated Financial Statements Audit - Open Recommendations
Establish a requirement for the Office of Grant Administration (OGA) or an appropriate AmeriCorps official to prepare a summary report, as part of the closeout process, verifying all required grantee information has been received and accepted, and the recovery amount reconciles to the underlying support (e.g., Notice of Grant Award for de-obligation, Final Federal Financial Report, Payment Management Services, etc.).