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(b) Background on Significant, Anomalous, and Highly Suspect Billing Activity Recently, ACOs and other interested parties have raised concerns about an increase in billing to Medicare for selected intermittent urinary catheter supplies on Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) claims in CY 2023, alleging that the increase in payments represents fraudulent activity (the alleged conduct)
Department of Health and Human Services, Robert F
In the CY 2024 PFS final rule (87 FR 70169), the total estimated burden for the CY 2024 performance period/2026 MIPS payment year was 724,212 hours at a cost of $81,322,556 (see Table 77, row a)