Industry Resources | May 7, 2020
An Estimated 87 Percent Of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare’s Medical Necessity Or Documentation Requirements
On April 8, 2020, the Office of the Inspector General (OIG) for the federal Department of Health and Human Services published a report on an audit of 36,120 inpatient claims with nearly $1 billion in total Medicare payments. OIG's objective was to determine whether inpatient psychiatric facilities complied with Medicare coverage, payment, and participation requirements for services provided in FYs 2014 and 2015 that resulted in outlier payments . . .