Report Materials
EXECUTIVE SUMMARY:
The primary objective of the review was to evaluate the medical necessity of the care and services provided and the reasonableness of the charges and reimbursements made during the period from January 1, 1994 through December 31, 1994.
The Operation Restore Trust reviewers questioned $95,442 in charges reported for the 32 sample beneficiaries in our study. This amount comprises $74,730 related to physical, occupational and speech therapy services; $14,827 of unallowable supplies; $5,530 in unallowable laboratory charges; and $355 in inappropriate drug payments. Therefore, we are recommending an adjustment of the above charges. In addition, we request that the fiscal intermediary conduct a focused review of all rehab therapies since the period of our review in order to recoup overpayments made to this skilled nursing facility.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.