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CMS to reduce audit burden on physicians

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In what might be seen as further evidence that Health & Human Services Secretary Tom Price, M.D., is taking a much more pro-physician ┬ástance toward physicians paid by Medicare than his predecessors, the Centers for Medicare & Medicaid Services (CMS) is, in the words of Medscape “lightening the audit burden on physicians by rolling out a new approach to claims review that targets fewer providers and requires the review of fewer claims than the current approach does. This new policy reduces the likelihood that physicians who follow sound billing practices will be audited.”

“CMS explained that it was revising its medical review process to target only specific providers or suppliers who have billed Medicare for particular services, rather than all of them. Referring to the two-step process of identifying providers who have made billing errors and then educating them, the agency calls this new approach Targeted Probe and Educate (TPE). It replaces the current Probe and Educate program, which began in 2014 and targets all providers who bill for particular services or items.”

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