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OIG: 1 in 4 SNF Medicare claims contain errors

November 15, 2012

A quarter of Medicare claims filed by skilled nursing facilities contain errors, according to a recent report from the Department of Health and Human Services Office of Inspector General. OIG conducted a medical record review of a stratified random sample of SNF claims from 2009 and found that one in four claims submitted to Medicare contained errors. The most common error identified was incorrect coding, especially for ultrahigh therapy cases. The report also found a high error rate for Minimum Data Set information submitted by SNFs. In the report, the Centers for Medicare & Medicaid Services agreed with OIG's recommendations to reduce inappropriate SNF payments, including increasing and expanding reviews of SNF claims and monitoring compliance with new therapy assessments.