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First Coast Service Options’ Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction N Generally Did Not Comply With Medicare Requirements

The payments that First Coast Service Options (FCSO) made to providers in Jurisdiction N (Florida, Puerto Rico, and the U.S. Virgin Islands) for hospital outpatient dental services generally did not comply with Medicare requirements. Of the 100 dental services in our stratified random sample, 95 did not comply with Medicare requirements. Using our sample results, we estimated that FCSO improperly paid providers in Jurisdiction N at least $1 million from January 1, 2012, through August 31, 2014.

Filed under: Centers for Medicare and Medicaid Services