Government/Law
These days, if you are a Medicare provider, the phrase “lack of medical necessity,” most likely, makes you twitch with anxiety. That is because, for the past five years, Medicare auditing contractors (i.e., ZPIC, MAC, and RAC) have denied more Medicare Parts A and B claims for “lack of medical necessity” than for any other reason, thus costing providers hundreds of millions of dollars in free services and products. Importantly, claims denied for “lack of medical necessity” are rarely deemed fraudulent, but instead considered “technical violations.” The reason more claims are denied for “lack of medical necessity” than anything else… Full Story