Office of Inspector General Audit Prompts New Phlebotomy Travel Regulations

September 07, 2021

The U.S. Department of Health and Human Service’s Office of the Inspector General (OIG) just released a report suggesting that the Centers for Medicare and Medicaid Services (CMS) needs to promulgate regulations on phlebotomy travel allowances. The report, which reviews several audits of Medicare administrative contractor (MAC) payments for phlebotomy travel allowances, found that at least two MACs paid providers for phlebotomy travel allowances that did not comply with Medicare guidance. According to OIG, less than half (109 of 202 claims reviewed) complied with Medicare guidance. OIG identified errors related to incorrect prorated mileage, incorrect payment rates, and inadequate documentation. 

CMS is expected to release regulation to clarify provider guidance related to prorating mileage on claims for phlebotomy travel allowances or issue further guidance.

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