State Member Michael Somers
State Member-
Michael Somers started the discussion Sharing MFCU Recoveries with MCE's and Incentive Payments Under 42 CFR 438.6(a) in the forum State Only Forum a year ago
Sharing MFCU Recoveries with MCE's and Incentive Payments Under 42 CFR 438.6(a)
Hello,
Massachusetts is beginning to implement a policy that I know has been implemented in other states where will will begin to share a certain portion of MFCU recoveries with MCE’s if they have made a referral of the provider that led to the recovery. CMS has said that it’s fine to have such an arrangement in our contracts with the MCE’s…
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Michael Somers started the discussion Payment Suspension against 1 provider in group practice in the forum State Only Forum 2 years ago
Payment Suspension against 1 provider in group practice
Hi All,
I’m wondering what states consider to be the best practice regarding implementing a payment suspension following a credible allegation of fraud against one member of a group practice, when the group exclusively bills under the group ID not individual ID’s ( and also assuming the group itself nor other members of the group are implicated…
