On February 19, the US Department of Health and Human Services Office of the Inspector General (OIG) released a report detailing results of an audit of payments made by Noridian Healthcare Solutions, LLC for spinal facet-joint injections.
The report documents payments made from January 2018 through May 2019. Results of a sampled 100 claims indicated that 51 claims did not comply with one or more of the Medicare coverage requirements for spinal facet-joint injections: amounting to $12,546 in improper payments.
Based on this sample, the OIG estimates that Noridian made improper payments exceeding $4 million during the sample window. Noridian has concurred with the results of the audit and agreed to collect the $12,546 in improper payments made to physicians from the sampled claims and will contact the affected physicians directly. Noridian has also agreed to conduct education regarding Medicare billing requirements.