


New York State is eligible for this program and as indicated on the OMIG website. Check out this page to see what the criteria are to be eligible for these payments. One criteria is to have a proven system in place to check the LEIE exclusion screening list and other databases consistently.

Financial Reviews of Error Payments
One question that the OIG will attempt to answer this year is whether the CMS acted on the recommendation to target the error-prone providers to reduce payment errors. Furthermore, even if the CMS has not done so thus far, the CERT data may reveal patterns of errors where future intervention could reduce payment errors. These concerns are catching the attention of Republicans, US Senator Orrin Hatch (R-UT) and company calling the existing system of “pay-and-chase” a premise of policing after the fact upon which error checking is based — they want a better system more along the lines of “nip the error in the bud,” and prevent the fraud before it happens. With the newly elected Republican administration, and Republican control of all chambers of government, the preventative approach is likely to gain traction.
The Comprehensive Error Rate Testing (CERT) program has been used by CMS since 2003 to establish a national error rate for Medicare’s Fee-for-Service payments, in accord with the Improper Payments Information Act of 2002. A 2010 report identified those providers who appeared to be error prone, recommending that CMS target these providers, for contributing significantly to payment errors in the CERT program for provider-based reviews. Five years later, the FY 2015 reported national error rate for Medicare Fee-for-Service payments had not declined. Indeed, the national error rate was approximately 12.1 percent — that’s improper payments estimated at a cost of $43.3 billion.