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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-06-17-04002
Report Description

Medicare pays a specimen collection fee when it is medically necessary for a clinical laboratory technician to draw a specimen to perform a clinical diagnostic laboratory test. When a technician travels to a nursing facility or homebound patient and a specimen collection fee is payable, the Social Security Act provides for payment of a travel allowance. Prior work found that travel allowances were at risk of being overpaid.

Report Type
Audit
Agency Wide
Yes
Number of Recommendations
4
Questioned Costs
$0
Funds for Better Use
$2,373,676

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
267984 No $0 $0

We recommend that Novitas Solutions, Inc. educate providers on how to correctly calculate the prorated mileage for phlebotomy travel allowance payments.

267985 No $0 $0

We recommend that Novitas Solutions, Inc. educate providers on their responsibility to bring any previously paid claims to their MAC's attention if they were paid using the wrong rate.

267986 No $0 $0

We recommend that Novitas Solutions, Inc. educate providers on their responsibility to maintain adequate documentation to support payment for phlebotomy travel allowance payments.

267983 No $0 $2,373,676

We recommend that Novitas Solutions, Inc. work with the Centers for Medicare & Medicaid Services to clarify guidance to providers, which could have resulted in savings totaling an estimated $2,373,676 during our audit period.

Department of Health & Human Services OIG

United States