MACs Resume Medical Review on a Post-payment Basis

In August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. Audits were placed on hold, due to the COVID Pandemic Emergency. On June 3, 2021, CMS and the MACs have announced that they will begin conducting post-payment medical reviews for dates after March 2020. The Targeted Probe and Educate program (intensive education to assess provider compliance through up to 3 rounds of review) will restart. The MACs will continue to offer detailed review decisions and education as appropriate.

When notes are requested for audit, do not procrastinate. Send the notes in by the deadline date. Even though they may be auditing only one date of service, you are to send in all initial and subsequent notes to support the date of service. This means that you should send in the initial Medicare report, any SOAP notes, imaging reports, and ABN forms that support the date of service being audited.

Dr. Mario Fucinari will be holding upcoming classes on Medicare and other subjects. Are you audit-proof? To attend a live or virtual workshop, look at our course schedule. In addition, you can order personal training for you and your staff on our website. Don’t let an audit ruin everything you have worked for in your life!

Don’t forget to check our website for future classes, books, and consulting services!