Post-payment reviews have returned. Nationally, Medicare Administrative Contractors (MACs) have restarted post-payment reviews following their suspension due to COVID-19. In their weekly MLN Connects newsletter dated August 6, 2020, the Centers for Medicare and Medicaid Services (CMS) wrote, “Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020.
The Targeted Probe and Educate program (intensive education to assess provider compliance through up to three rounds of review) will restart later.” However, since August, MACs have now been cleared to open reviews to dates of service after March 1, 2020. The targeted Probe and Educate programs are still on hold and will be restarted at a later date, which has yet to be announced.