In a report, the office found that nearly half of Medicare Advantage organizations lack ordering national provider identifiers on at least some records. In addition, of those that do collect ordering national provider identifiers, 20 percent do not perform program integrity oversight using these identifiers.
“These findings indicate that there are unrealized opportunities for MAOs to use ordering NPIs to protect the MA program against fraud and abuse,” the office wrote.
Based on the new evaluation, the office recommended that CMS encourage Medicare Advantage organizations to perform integrity oversight using national provider identifiers.
Access the full brief here.
More articles on healthcare finance:
Northwell hospital charged 30x more for COVID-19 tests in its ED
CMS recouping advanced Medicare payments
Billing errors resulted in $23.6M in overpayments to HCA hospital, inspector general finds
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
