You may not have yet gotten a records request from CMS for its Comprehensive Error Rate Test (CERT) report, but you probably will in the near future.
The agency samples 100,000 submitted Medicare claims annually to come up with data for the report, which produces valuable information on what the claims error rate is and what sorts of mistakes practices are making.
The agency samples 100,000 submitted Medicare claims annually to come up with data for the report, which produces valuable information on what the claims error rate is and what sorts of mistakes practices are making.
There hasn't been a lot of news on the latest CERT data. As we've previously reported, CMS didn't release its usual mid-year CERT report for 2009 because it was reviewing the methodology used to compile the results.
Well, CERT's back and the program's scope has been expanded. I spoke to a CMS official who assured me that the skipped mid-year report didn't mean that CERT was "on hold." The program "has never been on hold," she said.
In fact, "CERT is now doing hospital inpatient reviews to establish the Medicare error rate," the official said. The hospital inpatient error rate had previously been determined by the Hospital Payment Monitoring Program (HPMP); however the error rate measuring component of HPMP has now been merged into CERT, she said.
A few hospitals, including Massachusetts General - notable for having treated the late Sen. Ted Kennedy's brain tumor last year - report a noticeable uptick in the number of CERT requests they've received in recent months.
So make no mistake: CERT is back. The next CERT report is expected around Nov. 15, and could contain significant changes to methodology from the previous report, released in May 2008.