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Wisconsin Physicians Service's Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction 5 and Jurisdiction 8 Generally Did Not Comply With Medicare Requirements

Wisconsin Physicians Service's (WPS) (located in Madison, Wisconsin) payments to providers in Jurisdiction 5 (Iowa, Kansas, Missouri, and Nebraska) and Jurisdiction 8 (Indiana and Michigan) 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 WPS improperly paid providers approximately $1.3 million for dental services provided during the period January 1, 2013, through December 31, 2014.

Filed under: Centers for Medicare and Medicaid Services