Open Recommendations
Recommendation Number | Significant Recommendation | Recommended Questioned Costs | Recommended Funds for Better Use | Additional Details | |
---|---|---|---|---|---|
22-E-09-015.01 | No | $0 | $0 | ||
CMS should Issue new guidance on the appropriate use of MAO clinical criteria in medical necessity reviews. | |||||
22-E-09-015.02 | No | $0 | $0 | ||
CMS should Update its audit protocols to address the issues identified in this report, such as MAO use of clinical criteria, and/or examine particular service types. | |||||
22-E-09-015.03 | No | $0 | $0 | ||
CMS should direct MAOs to take additional steps to identify and address vulnerabilities that can lead to manual review errors and system errors. |