Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances

Submitting OIG:

Department of Health & Human Services OIG

Report Description:

Medicare pays a specimen collection fee when it is medically necessary for a clinical laboratory technician to draw a specimen to perform a clinical diagnostic laboratory test. When a technician travels to a nursing facility or homebound patient and a specimen collection fee is payable, the Social Security Act provides for payment of a travel allowance. Prior work found that travel allowances were at risk of being overpaid.

Date Issued:

Thursday, January 16, 2020

Agency Reviewed / Investigated:

Department of Health & Human Services

Submitting OIG-Specific Report Number:

A-06-17-04002

Component, if applicable:

Centers for Medicare & Medicaid Services

Location(s):

Agency-Wide

Type of Report:

Audit

Questioned Costs:

Funds for Better Use:

$2,373,676

Number of Recommendations:

View Document:

Attachment	Size
61704002.pdf	516.19 KB

Additional Details Link:

https://www.oig.hhs.gov/oas/reports/region6/61704002.pdf

Related Open Recommendations

Recommendation Number	Recommendation Status	Significant Recommendation
267983	Open	No
We recommend that Novitas Solutions, Inc. work with the Centers for Medicare & Medicaid Services to clarify guidance to providers, which could have resulted in savings totaling an estimated $2,373,676 during our audit period.
267984	Open	No
We recommend that Novitas Solutions, Inc. educate providers on how to correctly calculate the prorated mileage for phlebotomy travel allowance payments.
267985	Open	No
We recommend that Novitas Solutions, Inc. educate providers on their responsibility to bring any previously paid claims to their MAC's attention if they were paid using the wrong rate.
267986	Open	No
We recommend that Novitas Solutions, Inc. educate providers on their responsibility to maintain adequate documentation to support payment for phlebotomy travel allowance payments.

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

267983

Open

We recommend that Novitas Solutions, Inc. work with the Centers for Medicare & Medicaid Services to clarify guidance to providers, which could have resulted in savings totaling an estimated $2,373,676 during our audit period.

267984

Open

We recommend that Novitas Solutions, Inc. educate providers on how to correctly calculate the prorated mileage for phlebotomy travel allowance payments.

267985

Open