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Improper Medicare Payments

Improper Medicare Payments The Government Accountability Office (GAO) has estimated that Medicare made almost $48 billion in improper payments in fiscal year 2010, about 38% of Medicare's total payments of $125.4 billion. In testimony before a House subcommittee on July 28, GAO officials said the Centers for Medicare & Medicaid Services (CMS) faced challenges in designing and implementing internal controls to effectively prevent or detect and recoup improper payments. Improper payments include both overpayments and underpayments (http://tinyurl.com/3l6339x). To improve the situation, the GAO recommended that the CMS strengthen clinician enrollment standards and procedures, improve prepayment reviews, focus postpayment reviews on vulnerable areas, improve oversight of contractors, and develop a robust process to address vulnerabilities. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Improper Medicare Payments

JAMA , Volume 306 (10) – Sep 14, 2011

Improper Medicare Payments

Abstract

The Government Accountability Office (GAO) has estimated that Medicare made almost $48 billion in improper payments in fiscal year 2010, about 38% of Medicare's total payments of $125.4 billion. In testimony before a House subcommittee on July 28, GAO officials said the Centers for Medicare & Medicaid Services (CMS) faced challenges in designing and implementing internal controls to effectively prevent or detect and recoup improper payments. Improper payments include both...
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Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2011.1254
Publisher site
See Article on Publisher Site

Abstract

The Government Accountability Office (GAO) has estimated that Medicare made almost $48 billion in improper payments in fiscal year 2010, about 38% of Medicare's total payments of $125.4 billion. In testimony before a House subcommittee on July 28, GAO officials said the Centers for Medicare & Medicaid Services (CMS) faced challenges in designing and implementing internal controls to effectively prevent or detect and recoup improper payments. Improper payments include both overpayments and underpayments (http://tinyurl.com/3l6339x). To improve the situation, the GAO recommended that the CMS strengthen clinician enrollment standards and procedures, improve prepayment reviews, focus postpayment reviews on vulnerable areas, improve oversight of contractors, and develop a robust process to address vulnerabilities.

Journal

JAMAAmerican Medical Association

Published: Sep 14, 2011

Keywords: medicare

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