In 2011, the 54 Senior Medicare Patrol Projects had 5,671 active volunteers, a 14-percent increase from 2010. These volunteers conducted 66,303 one-on-one counseling sessions and 11,109 group education sessions. In 2011, 431,128 beneficiaries attended group education sessions, an increase from 298,097 in 2010. At the same time, Medicare funds recovered that were attributable to the projects were $19,283 in 2011. Total savings to Medicare, Medicaid, beneficiaries, and others were $32,941. Additionally, cost avoidance on behalf of the Medicare program, the Medicaid program, beneficiaries, and others, totaled $247,850. One of the projects, however, reported referring two large-dollar cases to a Medicare contractor. In one of these cases, the Medicare contractor is seeking to recover $2.9 million in overpayments from a provider who was identified by the project. Please click here for more information: Senior Medicare Patrol
Day: July 18, 2012
NOTIFICATION OF PREPAYMENT REVIEW FOR ORTHOTIC AND PROSTHETIC HCPCS CODES
NAS Jurisdiction D DME MAC Medical Review will be initiating a widespread prepayment probe review of claims for each of the following HCPCS codes: L0631, L0637, L0830, L4360, L1960, and L1970. This review is being initiated based on the results of Comprehensive Error Rate Testing (CERT) analysis and previous review results. In order to evaluate compliance with Medicare coverage and coding rules, all suppliers billing Jurisdiction D for HCPCS codes listed above are subject to this review. Suppliers of the selected claims will receive an Additional Documentation Request (ADR) letter asking for specific information to determine if the item billed complies with the existing reasonable and necessary criteria. Failure to supply the requested information within 45 days of the date on the letter will result in the claim being denied. The ADR letter will provide instruction for submitting documentation. Please click here for more information: Noridian Notification
DME INFO 