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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-09-22-03010
Report Type
Audit
Questioned Costs
$888,169,038
Funds for Better Use
$0

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
23-A-09-085.01 No $0 $0

We recommend that the Centers for Medicare & Medicaid Services direct the appropriate Medicare contractors to review claims billed under CPT code 81408 for our audit period to determine whether they complied with Medicare requirements.

23-A-09-085.02 No $888,169,038 $0

We recommend that the Centers for Medicare & Medicaid Services direct the appropriate Medicare contractors to determine the amount of improper payments for the claims that did not comply with Medicare requirements and, for those that are within the 4-year claim-reopening period, in accordance with CMS's policies and procedures, recover up to $888,169,038 for claims that were at risk of improper payment during our audit period.

23-A-09-085.03 No $0 $0

We recommend that the Centers for Medicare & Medicaid Services direct the appropriate Medicare contractors to based upon the results of this audit, notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return 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.

Department of Health & Human Services OIG

United States