The department suspended most fee-for-service claims audits on March 30 due to the COVID-19 pandemic. The suspension applied to prepayment medical reviews conducted by Medicare Administrative Contractors and post-payment reviews.
CMS cited changes in states’ reopening policies and the importance of the reviews as reasons for resuming the audits.
“If selected for review, providers should discuss with their contractor any COVID-19-related hardships they are experiencing that could affect audit response timeliness,” reads the FAQ document. “CMS notes that all reviews will be conducted in accordance with statutory and regulatory provisions, as well as related billing and coding requirements.”
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