CMS Will Enforce Integrity Requirement Using Claims Edits

CMS will implement claims edits to enforce a 2010 requirement that certain Medicare claims for home health, Part B laboratory and imaging services, and durable medical equipment identify the ordering or referring physician, according to an AHA News Now report.  

Effective May 1, CMS will require that for a claim to be paid, the listed ordering or referring physician must be currently enrolled in Medicare and eligible to order or refer the service or item being billed.

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CMS Touts Lower Healthcare Spending, Readmissions Under PPACA
CMS Releases FAQs on Medicaid RACs


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