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HHS OIG: Medical Review of Claims for the Fiscal Year 2006 Comprehensive Error Rate Testing Program
Executive Summary: “In two reviews of beneficiaries’ medical records, KePRO, an independent medical review contractor, identified errors in claims for durable medical equipment, prosthetics, orthotics, and supplies (DME) that the Comprehensive Error Rate Testing (CERT) contractor had not identified. The Centers for Medicare and Medicaid Services (CMS) used the results of the CERT contractor’s medical review to produce a DME paid claim error rate for fiscal year (FY) 2006.”
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