Which agency instituted the Comprehensive Error Rate Testing program?

Which agency instituted the Comprehensive Error Rate Testing program?

• A. Department of Justice
• B. Centers for Medicare and Medicaid Services
• C. Department of Health and Human Services
• D. Office for Civil Rights

Answer: (B)

The main idea here is that CERT, the Comprehensive Error Rate Testing program, is a specific initiative created by the Centers for Medicare & Medicaid Services to measure improper payments in Medicare Fee-For-Service. It works by sampling a subset of claims, verifying them against medical records, and determining whether the payments were correct. This program helps quantify the national error rate and supports efforts to improve payment accuracy and reduce waste and improper payments in Medicare and Medicaid. Why this agency is the right one: CERT is designed to assess and improve Medicare payment integrity, which is explicitly within the purview of CMS. While the Department of Health and Human Services is the parent department that houses CMS, the program itself was instituted by CMS as a targeted initiative. The other entities listed—Department of Justice or the Office for Civil Rights—handle enforcement and civil rights issues, not the ongoing measurement and reporting of Medicare payment accuracy that CERT covers.

The main idea here is that CERT, the Comprehensive Error Rate Testing program, is a specific initiative created by the Centers for Medicare & Medicaid Services to measure improper payments in Medicare Fee-For-Service. It works by sampling a subset of claims, verifying them against medical records, and determining whether the payments were correct. This program helps quantify the national error rate and supports efforts to improve payment accuracy and reduce waste and improper payments in Medicare and Medicaid.

Why this agency is the right one: CERT is designed to assess and improve Medicare payment integrity, which is explicitly within the purview of CMS. While the Department of Health and Human Services is the parent department that houses CMS, the program itself was instituted by CMS as a targeted initiative. The other entities listed—Department of Justice or the Office for Civil Rights—handle enforcement and civil rights issues, not the ongoing measurement and reporting of Medicare payment accuracy that CERT covers.