CMS audits to resume August 3

At the end of March 2020, CMS suspended Medicare Fee-for-Service (FFS) review due to the COVID-19 public health emergency (PHE). CMS recently announced that it plans to discontinue that suspension on August 3 due to the reopening of states and the importance of these medical review opportunities. Accordingly, pre-payment reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program (TPE), and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC) are set to resume in just a few short weeks. This is expected regardless of the status of the PHE. CMS will apply waivers and flexibilities in effect at the time of the dates of service for any claims selected for review.

To review the FAQ issued on this topic, please click here.

For assistance with any Medicare FFS reviews, please reach out to the attorneys listed below.