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News & Press: Government Affairs News

CMS Pauses Fee-for-Service Medical Reviews

Thursday, April 2, 2020   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Baltimore, MD - The Centers for Medicare and Medicaid Services (CMS) has suspended most Medicare fee-for-service medical reviews, according to FAQs released by the agency. Pre-payment medical reviews and post-payment reviews conducted by Medicare Administrative Contractors (MACs), Supplemental Medical Review Contractors (SMRC), and Recovery Audit Contractors (RACs) are suspended for the duration of the public health emergency caused by COVID-19. Current post-payment reviews will be suspended and released from review according to CMS.

CMS has reserved the ability to conduct pre- and post-payment medical reviews during or after the public health emergency if there is an indication of potential fraud.

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