AMCNO Participates in CMS Region V Update

Recently the AMCNO was pleased to participate in a Center for Medicare and Medicaid Services (CMS) Region V Provider Update session. Facilitating the meeting was Dr. Derek Robinson, Chief Medical Officer for CMS Region V. Presenters were on hand from CMS, CGI (the RAC contractor for Ohio) CGS (the MAC contractor for Ohio) and representatives from Medicare Advantage. Dr. Robinson asked the AMCNO to make our members aware of the recent Office of the Inspector General (OIG) report to CMS regarding place-of-service coding for physician services processed by Medicare Part B contractors. The purpose of the OIG sample audit was to determine whether physicians correctly coded nonfacility place of service codes on selected Part B claims. The report found that a select sampling of physicians did not always correctly code nonfacility place of service codes on Part B claims which had resulted in overpayments. Based upon the sample results the OIG estimated that Medicare contractors nationwide overpaid physicians $9.5 million for incorrectly coded services provided during calendar year 2009. Based upon these findings the OIG has recommended that CMS recover the overpayments and Medicare contractors have also been instructed to reopen claims associated with these type of services coupled with enhancing education to physicians regarding the importance of correctly coding the place of service. More information on the Region V meeting will be included in the next issue of the Northern Ohio Physician magazine.