Medicare Prepayment audits to start Aug. 27 in 7 states | Heart and Vascular Health |

Take Home Message - Prepayment review has not been done before by CMS.  Previously this was reported to be for cardiac procedures such as angioplasty and defibrillators.


The Centers for Medicare & Medicaid Services finally gave the official word on when hospitals should brace themselves for prepayment audits--Aug. 27, the agency quietly announced on its website.

The official launch date of Aug. 27 provides the timeline as to when CMS will target hospitals in states with high volumes of fraud or error-prone providers (Florida, California, Michigan, Texas, New York, Louisiana, Illinois) or many short inpatient stays (Pennsylvania, Ohio, North Carolina, Missouri).

The goal is to cut improper payments before they even happen. Shifting away from the pay-and-chase method, Medicare Recovery Auditors (RAC) will review claims before payment to ensure that providers comply with all Medicare payment rules.