Medicare Targets Billing Fraud at Inpatient Rehab Facilities

Inpatient rehabilitation facilities would have a harder time being paid for fraudulent and questionable Medicare billings under a proposed new demonstration project revealed Monday by the Trump administration.

The Centers for Medicare & Medicaid Services is seeking public comment on a “Review Choice Demonstration” for inpatient rehabilitation facility services. The project would allow providers to show their compliance with CMS policies through either a 100% pre-claim review process or a 100% post-payment review process. The reviews would continue until the facility reaches a 90% claim-approval rate, based on a minimum of 10 pre-claim requests or claims submitted.

Once a facility ...